Expert Perspectives

Medcan’s guide to heart health

Understanding your risks, steps for early detection, and science-backed lifestyle strategies for optimal heart health

Heart disease is the second leading cause of death in Canada, and nearly 1 in 12 Canadian adults over age 20 live with a diagnosed heart disease. And according to recent statistics on cardiovascular disease in Canada, there’s been a long‑term upward trend, with men having higher prevalence than women, and age being a factor.

While men are twice as likely as women to suffer a heart attack, women are more likely to be diagnosed about ten years later (in their 60-70s), at a point where the disease is more advanced by the time it’s detected.

However, despite its high prevalence for both sexes, the outlook is far from predetermined. Research shows that up to 80% of premature heart disease and stroke are preventable.

By being proactive about your health, you can meaningfully reduce your risk. It’s why Medcan’s preventive healthcare approach places heart health as a core pillar of full body health.

In this guide, we outline the most common heart conditions, biomarkers that signal optimal heart health, tests that clarify your individual risk, and science‑backed lifestyle strategies that make a positive impact on your cardiac health.

Your heart: a masterwork of human biology

Most people know, at least in a general sense, how essential their heart is to their health. But every so often, it’s worth a pause to truly appreciate the scope of what this vital organ does for you each day.

Here are some fast facts on the roles your heart performs to keep your health in check:

Your heart is part of a vast biological network – the circulatory system – which spans roughly 96,000 kilometres of vessels to create a high‑speed, always‑on delivery network.
The heart beats about 100,000 times each day, pushing life‑sustaining blood through your body.
With every beat, it delivers the oxygen and nutrients your cells need to make energy while also carrying away waste that would otherwise build up.
The constant circulation of blood supports every organ, from your brain to your muscles.
The heart defends against illness. It delivers white blood cells and antibodies to fight infection. Platelets, which are disc‑shaped cell fragments in your blood, simultaneously jump‑start healing by forming clots that stop bleeding.

At every moment, your heart is there for you, working non‑stop, and powering an intricate system that keeps your body moving, thinking, healing – and alive.

According to Medcan’s Clinical Director of Cardiology, Dr. Beth Abramson, “By the time you reach mid-life, you have a 50% chance of developing cardiovascular disease, and 1 in 5 have risk factors at a younger age. And a lot of heart disease is preventable.”

"By the time you reach mid-life, you have a 50% chance of developing cardiovascular disease, and 1 in 5 have risk factors at a younger age."
Dr. Beth Abramson, Medcan’s Clinical Director of Cardiology

There are two steps that everyone can take to significantly reduce their risk of developing cardiovascular disease – even if they have a genetic predisposition.

Understand your body: know your personal level of risk. This includes regularly testing cardiac biomarkers and attending annual check-ups like Medcan’s Annual Health Assessment. It also involves knowing your family history, recognizing symptoms, and being informed about the factors that influence heart health.
Targeted prevention: based on your personal risk and biomarkers, this step means focusing on your nutrition, physical activity, stress management, and more. It may also mean additional screenings or medication to monitor and manage specific risk factors, like high cholesterol, arterial plaque build-up, or genetic predispositions. Some people may also want to adopt heart‑healthy lifestyle behaviours earlier on if they have a genetic risk.

These preventative steps can help you keep your system in harmony and increase your chances of avoiding one of the major cardiovascular diseases.

Understanding cardiovascular disease: three classifications

Cardiovascular disease (CVD) is the umbrella term for conditions that impair the heart and blood vessels. They are complex diseases that can more simply be classified in three ways.

Atherosclerotic cardiovascular diseases: a group of conditions caused when the accumulation of fatty substances – known as plaque – build up and cause the arteries to narrow, restricting blood flow to the heart. (For a visual of what this looks like, visit this page.) They are also the most significant cardiovascular conditions in Canada, affecting ~10% of Canadian men and ~7% of Canadian women (20+).
Structural and functional heart diseases: these types of CVD affect how the heart pumps or how its valves function. If ignored, these can develop into heart failure, problems with the heart’s electrical system, hospitalization, increased stroke risk, and life‑threatening complications.
Electrical heart disorders: also known as arrhythmias, these are diseases where the heart beats too fast, too slow, or irregularly. The root of these problems is electrical, rather than structural or related to blood‑vessel issues.

With a preventative approach that includes annual screening and lifestyle maintenance, most people can avoid these diseases. However, there are some risk factors that may increase the incidence of developing them that are also important to understand.

Are you at risk? ‘Non-modifiable’ and ‘modifiable’ risks

Two types of risk factors increase your chance of developing a cardiovascular disease: risks you can’t change and ones you can.

Factors you can’t change are also known as ‘non-modifiable risks.’ They include:

Age: risk rises as you get older
Sex: men tend to develop CVD earlier; women’s risk rises after menopause
Family history: early CVD in a first‑degree relative raises risk
Genetics: inherited conditions influence cholesterol, blood pressure, clotting, and more

‘Modifiable risks’ are factors you can test for, track, and control with positive lifestyle habits. Here are the scientifically backed risks that increase your chances of cardiovascular disease, and what you want to avoid:

High blood pressure (hypertension)
High LDL cholesterol / high ApoB
Smoking or vaping
Physical inactivity
Poor diet (high in saturated fat, trans fat, salt, added sugars)
Overweight or obesity
Type 2 diabetes and insulin resistance
Excessive alcohol use
Chronic stress

It’s useful to understand your non‑modifiable risk factors early in life because you can take proactive steps sooner. Getting objective, measurable metrics to confirm your true risk level is essential.

Cardiovascular disease prevention tests

Three categories of test can give you a concrete picture of what’s going on inside your body and give you and your doctor tangible information to work with, to decide what’s best for you. They are:

Arterial health tests
Functional heart tests
Genetic screening

Arterial health tests

Arterial tests detect early blood vessel changes before they cause symptoms. Healthy arteries should be smooth, flexible conduits. Atherosclerosis is what happens when walls start thickening, and plaque accumulates inside the vessel, narrowing the lumen – the medical name for the open, hollow space inside the blood vessel where blood flows – and impeding flow. Once narrowing exceeds ~70%, medical intervention is often required and may include medications, stents, or other procedures.

Biomarkers that assess arterial health

One way to gather insights on arterial health is with a comprehensive lipid panel that includes critical cardiac biomarkers, such as Medcan’s Annual Health Assessment.

Below are the key biomarkers we track during your Annual Health Assessment, and a definition of how each contributes to valuable insights on arterial health.

Glucose: screen for and diagnose diabetes and monitors effectiveness of treatment of diabetic patients over time.
Hemoglobin A1C (HbA1c): a marker for blood sugar metabolism over the prior 3 months, this test is used to screen for and diagnose diabetes and monitors effectiveness of treatment of diabetic patients over time.
Total Cholesterol: the sum of all fractions of cholesterol in an individual’s blood.
Low Density Lipoprotein Cholesterol (LDL): a type of “bad” cholesterol that can lead to plaque buildup in arteries, which can increase an individual’s risk of cardiovascular conditions, such as heart attack and stroke.
Triglycerides: a type of fat that at higher levels can increase an individual’s risk of cardiovascular conditions, such as heart attack and stroke.
Total Cholesterol/HDL Ratio: a ratio of an individual’s total cholesterol to their “good” cholesterol. A higher ratio indicates a higher risk of cardiovascular conditions, such as heart attack and stroke.
Non-HDL Cholesterol: the sum of all the “bad” types of cholesterol in an individual’s blood, a higher level suggests an increased risk of cardiovascular conditions, such as heart attack and stroke.
Triglycerides/HDL Ratio: a ratio of triglycerides to “good” cholesterol (HDL). A higher ration is associated with an increased risk of cardiovascular conditions, such as heart and stroke.
Apolipoprotein B (ApoB): a protein associated with the “bad” lipoproteins in the blood that are involved in plaque buildup in an individual’s arteries. A higher level indicates a higher risk of cardiovascular conditions, such as heart attack and stroke. This test is performed annually.
Lipoprotein (a) (Lp(a)): a genetically determined lipoprotein that carries cholesterol in the blood. A higher Lp(a) level increases an individual’s risk of cardiovascular disease, such as heart attack and stroke. It does not significantly change during a person’s lifetime, so it is performed once in a lifetime.
C-Reactive Protein (High Sensitivity) (hsCRP): a marker for inflammation that is linked to risk of cardiovascular conditions, such as heart attack and stroke.
Ankle–Brachial Index (ABI): a simple, non‑invasive comparison of ankle vs. arm blood pressure to detect peripheral artery disease (PAD). A low ABI also predicts future cardiovascular events.

Many experts now recommend that everyone has their lipoprotein Lp(a) measured at least once in their lifetime. About 1 in 5 people have elevated Lp(a), which is a sticky, fatty particle some are born with that causes higher levels of plaque to adhere to artery walls. An elevated Lp(a) often justifies more aggressive LDL‑lowering strategies.

Another test that evaluates arterial health is a carotid intima–media thickness (CIMT), which can be added to your Annual Health Assessment as part of one of the tests that are part of a suite of Enhanced Heart Health.

Carotid intima–media thickness (CIMT) is an ultrasound that measures arterial wall thickness. Most people feel no symptoms until an artery is ~70% narrowed, so a CIMT helps identify risk well before that point.

Additionally, for those that want a deeper dive into the state of their coronary arteries, there’s a coronary artery calcium scoring test.

Coronary artery calcium scoring uses a CT scan to identify plaque that has been present long enough to harden. When plaque builds in the coronary arteries, it starts off soft. Over the years, plaque can undergo a natural process where calcium gets deposited into it, causing it to harden. Calcified plaque indicates a long‑standing state of disease.

Medcan helps facilitate calcium artery scoring for those interested in completing it.

Functional heart health tests

Functional tests measure how effectively your heart works as a pump.

One biomarker that provides insights on heart function, evaluated during your Annual Health Assessment, is high‑sensitivity troponin (hs‑troponin). Hs-troponin measures very tiny amounts of cardiac troponin, a protein released into the bloodstream when the heart muscle is damaged.

The high-sensitivity troponin test has now become the gold standard for early detection heart issues and is the same test that would be used to detect a heart attack in the emergency department. Medcan was the first to incorporate the test as part of proactive heart health testing. We found that in our clinical setting it can identify issues like valve or aorta problems before they become an emergency.

Additionally, you will complete a VO₂ sub‑max and electrocardiogram (ECG) to assess heart function. Here is a definition of each test:

VO₂ sub‑max test: a graded fitness test that estimates cardiorespiratory capacity. Improving your VO₂ over time through training lowers CVD risk.
Electrocardiogram (ECG): adhesive electrodes that measure the heart’s electrical signals to assess rate, rhythm, and conduction.

For deeper insights on function, Medcan offers an Enhanced Heart suite of tests, which can be purchased individually or together based on your needs and added to your Annual Health Assessment. They are as follows:

Echocardiogram: an ultrasound that assesses chamber sizes, muscle function, and valve performance.
Heart‑function blood test (NT‑proBNP): a hormone released when the heart is under strain. Testing for NT-prodBNP may provide insights on elevated levels prompt targeted follow‑up.
Trimethylamine‑N‑oxide (TMAO): a liver‑produced metabolite linked to atherosclerosis risk. Higher levels may warrant nutrition and lifestyle adjustments.

Genetic screening

To gain the most comprehensive insights into your inherited risk, you can complete genetic testing to evaluate genes related to cardiovascular health and risk factors.

Medcan’s Heart Health Genetic Screening provides a comprehensive understanding of your genetics. It’s a blood test that analyses 80+ genes related to cardiovascular disease. Results inform a personalized prevention plan and guide testing for at‑risk relatives. Medcan’s genetic screen can alert you to your risk for inherited heart conditions such as:

Familial Hypercholesterolemia (FH): a very high LDL cholesterol from childhood, which accelerates plaque buildup and increases the likelihood of developing early heart disease.
Hypertrophic Cardiomyopathy (HCM): a genetic heart condition where the heart muscle- especially the wall between the two lower chambers (the septum) becomes abnormally thick.
Long QT Syndrome: an acquired heart rhythm condition where the heart takes longer than normal to recharge between beats.
Brugada Syndrome: a rare genetic heart rhythm disorder that affects the heart’s lower chambers (the ventricles) and can cause dangerous arrhythmias, fainting, or even sudden cardiac death – often during rest or sleep.

When combined with a physical exam, family history review, body composition analysis, and abdominal ultrasound, all these tests provide deep insights on your cardiac health, giving you insights to action.

Prevention: science-backed steps we can all take to stay proactive

Lifestyle choices play an important role in minimizing your chances of developing a cardiovascular disease. From a high-level, there are six steps we can all take.

Eat a heart healthy diet
Exercise regularly
Maintain a healthy weight
Get quality sleep
Mitigate stress
Monitor blood pressure (which can be done more frequently than your annual assessment)

While these may sound like simple guidelines, the bottom line is, what to do as it pertains to each of the six, are completely unique to each person. What to eat, how to exercise, or minimize stress – these steps differ from person to person, body to body, and shift based on what you need at different times and stages of life.

However, when you know what your body needs by taking the time to test and measure, you have far more clarity about what to do. With real data, you can tailor your behaviours and focus on actions that move the right levers to continue to improve your overall health.

Heart health is central to all pillars of healthy living, impacting brain health, cancer prevention, metabolic health, and mobility.
Dr. Peter Nord, Medcan's Chief Medical Officer

Though individuals are unique, years of research point to lifestyle enhancements we can all take to keep our hearts healthy.

1. Eat a heart healthy diet

Certain dietary patterns like the Mediterranean, DASH, and Portfolio diets have been shown to lower cholesterol, blood pressure, and overall CVD risk.

Additionally, here are some other science-backed nutrition guidelines to stick to when it comes to fats, sugars, and other nutrients:

Reduce saturated fat intake to ≤9% of daily energy and replace it with monounsaturated and polyunsaturated fats to lower LDL cholesterol
Limit added sugars (<5–10% of energy) and avoid trans fats (already banned in Canada)
Increase fibre intake to at least 30 g per day, including 10 g of soluble fibre, which directly lowers LDL

Ultimately, current research suggests that a healthy dietary pattern should include a diet of lean proteins, nuts, legumes, whole grains, and omega‑3‑rich fish such as salmon, sardines, and trout.

Medcan has a comprehensive suite of nutrition programs to support you, led by renowned dietitian Leslie Beck. Here are additional resources you may find helpful:

2. Exercise

Exercise improves lipid profiles and reduces cardiovascular risk. Exercise is essential to help reduce your risk of not just cardiovascular disease but other conditions that can lead to heart issues, such as diabetes.

It is also important to challenge your heart, especially as you age because the impact of illness as you age can be more straining on your heart. If your heart is strong, you can be more resilient to serious illnesses and diseases.

Canadian cardiovascular and public health guidelines recommend 150 minutes/week of moderate‑to‑vigorous aerobic exercise, plus muscle‑strengthening activities.

Medcan offers personalized fitness programs for the exercise novice to the professional athlete. Here are additional resources to support your exercise needs:

3. Maintain a healthy weight

Numerous studies show weight control is linked to improved heart biomarkers. Reducing waist circumference also helps lower risk for diabetes, hypertension, and heart disease.

Refer to these guidelines for Canadian weight and waist circumference guidelines.

Whether you are having difficulties losing weight, or have lost weight and are struggling to keep it off, Medcan has one of the top weight management programs that offers effective and non-judgmental support as you work towards your goals. Here are some additional resources that may help:

4. Get quality sleep

Years of data, and numerous sleep studies, show that 7-9 hours is the scientifically proven standard to aim for when it comes to hours of sleep.

Quantity is important, but so is quality, and it depends on the balance and continuity you spend cycling through each of the sleep stages. During deep sleep phases, the body kicks into a repair mode that contributes to heart health. To know if your sleep is quality, it’s useful to know and track biomarkers for sleep.

If sleep is a major concern, it’s important to discuss this with your physician. They may recommend you engage in a sleep study, which provided critical insights that help confirm if you have a major sleep condition like sleep apnea or if other physiological or lifestyles factors are contributing to poor sleep.

To learn more about Medcan’s Sleep Study, which allows you to you to complete the study entirely from the comfort of your own home, visit this page.

For additional sleep resources, visit these articles and programs:

5. Mitigate stress

Stress can contribute to high blood pressure and unhealthy coping habits such as smoking and poor diet choices. Canadian cardiovascular guidelines emphasize stress management as part of heart‑healthy behaviours.

To avoid stress overload, engage in regular mindfulness exercises, physical activity, remain socially connected, and get good sleep.

At Medcan, we have a broad range of programs for mental health and well-being, with a team of experienced mental health professionals including psychologists, psychotherapists, and registered social workers. For your well-being needs, here are additional resources:

6. Monitor your blood pressure

Canadian guidelines encourage screening and early detection of cardiovascular issues by monitoring blood pressure. Hypertension Canada has national guidelines, emphasizing regular monitoring and early diagnosis to prevent complications.

With heart health being a critical pillar of lifelong vital, in addition to heart tests, Medcan offers a full suite of supports, that include weight management and nutrition, personalized fitness training, and mental well-being programs to help you make lifestyle modifications.

Final words and next steps

Your cardiovascular system is remarkable - and, importantly, highly protectable. With a clear understanding of your numbers, insight into your genetics, and small but steady lifestyle choices that genuinely fit your life, you can meaningfully improve your odds of avoiding one of Canada’s most common chronic diseases. More than that, you can build the foundation for a strong, resilient, heart‑healthy body that supports you for decades to come.

Take action

Understand your cardiovascular health risks and opportunities with a thorough biomarker test and physical evaluation. Medcan’s Annual Health Assessment provides a comprehensive view, tracking more than 100 biomarkers - including key indicators related to heart and metabolic health - to help identify risks early and guide personalized prevention.

For deeper metrics that indicate cardiovascular risk, Medcan’s suite of Enhanced Assessments helps you take a deeper dive into specific areas of health, like your heart. As a complement to our Annual Health Assessment, these enhancements provide greater insights into your heart health, cancer risk, genetics, longevity, and whole-body health, including liver health.

For more information on heart health , watch the video, All about proactive heart health screening here.

This article was written by Medcan’s editorial team in collaboration with our clinical innovation team and review and contribution from Dr. Peter Nord, Chief Medical Officer at Medcan.