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Blood pressure check
Blood pressure check


Physical exam frequency
Physical exam frequency


Definition:

All adults should visit their health care provider from time to time, even if they are healthy. The purpose of these visits is to:

  • Screen for diseases
  • Assess risk of future medical problems
  • Encourage a healthy lifestyle
  • Update vaccinations
  • Maintain a relationship with a doctor in case of an illness


Alternative Names:

How often you need a physical exam; Health maintenance visit



Information:

Even if you feel fine, it is still important to see your health care provider regularly to check for potential problems. Most people who have high blood pressure don't even know it. The only way to find out is to have your blood pressure checked regularly. Likewise, high blood sugar and high cholesterol levels often do not produce any symptoms until the disease becomes advanced.

There are specific times when you should see your health care provider. Age-specific guidelines are as follows:

AGE 18-39

  • Blood pressure screening:
    • Have your blood pressure checked every 2 years unless it is 120-139/80-89 Hg or higher. Then have it checked every year.
    • Watch for blood pressure screenings in your area. Ask your health care provider if you can stop in to have your blood pressure checked. Check your blood pressure using the automated machines at local grocery stores and pharmacies.
    • If the top number (systolic number) is greater than 130 or the bottom number (diastolic number) is greater than 85, call your doctor.
    • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
  • Cholesterol screening:
    • Men over age 34 should be checked every 5 years.
    • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
  • Dental exam:
    • Go to the dentist every year for an exam and cleaning.
  • Eye exam:
  • Immunizations:
    • After age 19, you should have a tetanus-diphtheria and acellular pertussis (TdAP) vaccine as one of your tetanus-diphtheria vaccines one time. You should have a tetanus-diphtheria booster every 10 years.
    • Your doctor may recommend other immunizations if you are at high risk for certain conditions such as pneumonia.
  • Men: Testicular exam:
    • Men should do a monthly testicular self-exam.
    • If you are not sure what you should be looking for, contact your health care provider for instruction.
  • Physical exam:
    • You should have two physical exams in your 20s.
    • During the first exam, ask to have your cholesterol checked. Other blood tests are not necessary for healthy young people.
    • Your height and weight should be checked at every exam.
  • Women: Breast self-exam:
    • Women may do a monthly breast self-exam.
    • Women should contact their health care provider immediately if they notice a change in their breasts, whether or not they do breast self-exams.
    • A complete breast exam should be done by a health care provider every 3 years for women age 20-40.
  • Women: Pelvic exam and Pap smear:
    • Women should have a pelvic exam and Pap smear every 1-2 years to check for cervical cancer, depending on the technique.
    • Screening should start within 3 years after first having vaginal intercourse or by age 21.
    • If you are over age 30 or your Pap smears have been negative for 3 years in a row, your doctor may tell you that you only need a Pap smear every 2-3 years.
    • Women who have had a total hysterectomy (uterus and cervix removed) may choose not to have Pap smears.
    • Women who are sexually active should be screened for chlamydia infection. This can be done during a pelvic exam.

AGE 40-65

  • Blood pressure screening:
    • Have your blood pressure checked every 2 years unless it is 120-139/80-89 Hg or higher. Then have it checked every year.
    • Watch for blood pressure screenings in your area. Ask your health care provider if you can stop in to have your blood pressure checked. Check your blood pressure using the automated machines at local grocery stores and pharmacies.
    • If the top number (systolic number) is greater than 130 or the bottom number (diastolic number) is greater than 85, call your doctor.
    • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
  • Cholesterol screening:
    • Men over age 34 should be checked every 5 years.
    • Women over age 44 should be checked every 5 years.
    • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
  • Colon cancer screening: People between the ages of 50 and 80 should be screened for colorectal cancer. African-Americans need to start screening at age 45. This may involve:
    • A stool test done every year.
    • Flexible sigmoidoscopy every 5 years along with a stool guaiac test.
    • Colonoscopy every 10 years.
    • Double-contrast barium enema.
    • Computed tomographic colonography (virtual colonoscopy).
    • People with risk factors for colon cancer such as long-standing ulcerative colitis, personal or family history of colorectal cancer, or history of large colorectal adenomas may need a colonoscopy more often.
  • Dental exam:
    • Go to the dentist every year for an exam and cleaning.
  • Eye exam:
    • If you have vision problems, continue to have an eye exam every 2 years.
    • Everyone (with or without eye problems) should begin to have regular eye exams every 2 years after age 40.
    • Once you turn 45, make sure that you have tonometry done to check for glaucoma .
  • Immunizations:
    • You should receive a flu vaccine every year after age 50.
    • Ask your doctor if you should get a vaccine to reduce your risk of pneumonia.
    • You should have a tetanus-diphtheria booster vaccination every 10 years.
    • A shingles or herpes zoster vaccination may be given once after age 60.
  • Physical exam:
    • Have a physical exam every 1-5 years.
    • Your height, weight, and body mass index (BMI) should be checked at each exam.
    • Routine diagnostic tests are not recommended.
  • Men: Prostate exam:
    • Most men age 50 or older should discuss screening for prostate cancer with their health care provider. African-American men and those with a family history of prostate cancer should start at age 45.
    • Screening tests may include the PSA blood test and a digital rectal examination.
  • Women: Breast exams:
    • Women may do a monthly breast self-exam.
    • Women should contact their doctor immediately if they notice a change in their breasts, whether or not they do self exams.
    • A complete breast exam should be done by a health care provider every year.
  • Women: Mammograms:
    • Women over the age of 40 should have a mammogram done every 1-2 years depending on risk factors to check for breast cancer .
  • Women: Osteoporosis screening:
    • All postmenopausal women with fractures should have a bone density test (DEXA scan).
    • Women under 65 who have risk factors for osteoporosis should be screened.
  • Men: Osteoporosis screening:
    • All men ages 50-70 with risk factors for osteoporosis should discuss screening with their doctor.
  • Women: Pelvic exam and Pap smear:
    • Women should have a yearly pelvic exam and Pap smear done to check for cervical cancer and other disorders.
    • If your Pap smears have been normal for 3 years in a row, your doctor may tell you that you only need a Pap smear to every 2-3 years.
    • Women who have had a total hysterectomy (uterus and cervix removed) may choose not to have Pap smears.
    • Women who are sexually active should be screened for chlamydia infection. This can be done during a pelvic exam.

AGE 65 AND OLDER

  • Abdominal aortic aneurysm screening:
    • Men between ages 65 - 75 who have smoked should have an ultrasound done once to screen for abdominal aortic aneurysms .
    • Others should discuss such screening with their health care provider.
  • Blood pressure screening:
    • Have your blood pressure checked every year.
    • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be watched more closely.
  • Cholesterol screening:
    • If your cholesterol level is normal, have it rechecked every 3-5 years.
    • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
  • Colon cancer screening: One of the following screening tests should be done:
    • A stool test every year
    • Flexible sigmoidoscopy every 5 years along with a stool guaiac test
    • Colonoscopy every 10 years
    • Computed tomographic colonography (virtual colonoscopy)

Note: Patients with risk factors for colon cancer, including long-standing ulcerative colitis, personal or family history of colorectal cancer, or history of large colorectal adenomas may need a colonoscopy more often.

  • Dental exam:
    • Go to the dentist every year.
  • Eye exam:
    • Have an eye exam every 2 years.
    • Make sure your health care provider checks for glaucoma.
  • Hearing test:
    • Have your hearing tested every year.
  • Immunizations:
    • If you are over 65, get a pneumococcal vaccine if you have never had before, or if you received one more than 5 years before your turned 65.
    • Get a flu shot every year.
    • Get a tetanus -diphtheria booster every 10 years.
    • A shingles or herpes zoster vaccination may be given once after age 60.
  • Men: Prostate exam:
    • All men should discuss prostate cancer screening with their health care provider.
    • Screening may involves a PSA test or digital rectal exam.
  • Physical exam:
    • Have a yearly physical exam.
    • With each exam, you should have your height and weight checked.
    • Routine diagnostic tests are not recommended unless your doctor finds a problem.
  • Women: Breast exams:
    • Women may do a monthly breast self-exam.
    • Women should contact their doctor immediately if they notice a change in their breasts, whether or not they do self exams.
    • A complete breast exam should be done by a health care provider every year.
  • Women: Mammograms:
    • Women should have a mammogram done every 1-2 years depending on risk factors to check for breast cancer.
  • Women: Osteoporosis screening:
    • All women should have a bone density test (DEXA scan).
    • Ask your doctor about the proper calcium intake and exercise needed to help prevent osteoporosis.
  • Men: Osteoporosis screening:
    • All men over age 70 should have a bone density test (DEXA scan).
  • Women: Pelvic exam and Pap smear:
    • Women should have a yearly pelvic exam and Pap smear done to check for cervical cancer and other disorders.
    • If your Pap smears have been negative for 3 years in a row, your doctor may tell you that you only need a Pap smear to every 2 - 3 years.
    • Women who have had a total hysterectomy (uterus or cervix removed) may choose not to have Pap smears.
    • If you are over 70 and your Pap smear has been normal for 10 years, or if your test results have been normal for 3 years in a row, you may choose not to have any more Pap smears.


References:

U.S. Preventive Services Task Force. Screening for Abdominal Aortic Aneurysm. Rockville, MD: Agency for Healthcare Research and Quality; February 2005.

U.S. Preventive Services Task Force. Screening for Chlamydial Infection. Rockville, MD: Agency for Healthcare Research and Quality; June 2007.

Smith RA, Cokkinides V, Brawley OW. Cancer Screening in the United States, 2008: a review of current American Cancer Society guidelines and cancer screening issues. CA Cancer J Clin. 2008;58(3):161-79. Epub 2008 Apr 28.

Gaziano JM, Manson JE, Ridker PM. Primary and secondary prevention of coronary heart disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, PA; Saunders Elsevier; 2007: chap 45.

American Diabetes Assocation. Standards of medical care in diabetes -- 2008. Diabetes Care. 2008;31(suppl 1):S12-54.

National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis . Feb. 2008. Accessed Feb. 22, 2008.




Review Date: 5/2/2009
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
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