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The Body Audit: Medical Tests Men In Their 40s Should Take

By Denise Schipani ; Updated August 14, 2017

“This is when the wheels start coming off the wagon!” says Dr. David K. Spindell, an internal medicine practitioner and divisional vice president of medical affairs at Abbott Diagnostics, and if you’ve dipped into this decade you know just what he means. Fit as you hopefully still are, you don’t recover quite so quickly after, say, a Sunday watching football with a giant bucket of chicken wings or, for that matter, a weekend warrior’s tennis game.

If you’ve let your weight creep up and your exercise regimen slack off, it's time to get back on the stick because your risk of conditions, including Type 2 diabetes, heart disease, stroke and cancer go up in this decade.

Most primary care physicians encourage annual routine physicals for men in their 40s, as any issues caught early are more easily treated. You also need to own up to your family history, and base decisions on preventive testing and care in part on that, says Dr. Gary Rogg, an internist at Montefiore Medical Center in Bronx, New York.

Take prostate cancer, for example. The American Cancer Society recommends an initial screen at 50. But if your dad got the disease before age 65 -- or if you are African-American -- you should start getting screened -- a blood test for a prostate specific antigen -- during this decade, says Rogg. Otherwise, your best staying healthy bet is to be vigilant about good health habits and getting annual physicals, especially that possibly previously avoided cholesterol screening.

Eye Exam

If you already wear glasses, get your vision checked regularly. The American Academy of Opthalmology recommends that those who’ve never gotten a comprehensive eye exam should book one now, because early signs of certain age-related eye problems -- cataracts, glaucoma, diabetic retinopathy, age-related macular degeneration -- may be lurking even without symptoms. See an ophthalmologist for a baseline exam, which will include an eye pressure test; pupil dilation so the doctor can look at your retina and optic nerve; and a test of visual acuity..

Meanwhile, if you find yourself holding the sports pages or your smartphone an arm’s length away, chances are you have presbyopia, a normal, middle-age-related shortening of your focus, also known as short arm syndrome. No serious worries here; all you need is a good pair of reading glasses. Either ask your doc for a prescription update or, if you don’t wear prescription glasses, a pair of readers from the drugstore will do the trick.

Blood Pressure Check

Any time you visit the doc you’ll get your BP checked. But the 40s are a time to get a handle on those numbers, as high blood pressure is a strong indicator of an increased risk for heart disease and stroke, especially if there are other red flags, like being overweight or a smoker, says Rogg. Numbers that should concern you: a systolic, or top, reading of between 120 and 139 and a diastolic, or bottom, reading between 80 and 89 puts you in a pre-hypertensive state, according to the American Heart Association. Hypertension is defined as blood pressure of 140/90 or higher.

Blood Sugar/Diabetes Test

With Centers for Disease and Prevention statistics showing that more than one-third of adults living in the U.S. are considered obese, it’s not surprising that Type 2, formerly called adult onset, diabetes is a huge and growing health concern, which is why finding out if you’re in danger of developing diabetes is critical. If you think being thin protects you from this disease, think again.

The American Diabetes Association recommends that by age 45 men be tested for Type 2 diabetes, most commonly with a fasting blood glucose test. A normal level is below 100 mg/dl. If your numbers come in between 100 and 125 mg/dl, you are considered pre-diabetic and you should consider it a wake-up call. According to the ADA, dropping a few pounds -- 7 percent of your bodyweight -- can put you back in the safe zone, but talk to your doctor about other lifestyle modifications. If your FPG is 126 mg/dl or above, you have diabetes, a condition that becomes chronic and sometimes deadly.

A more accurate diabetes screen is the hemoglobin A1C test. Whereas a fasting blood test is a snapshot in time, the A1C looks at a protein in the blood that changes in the presence of too much blood sugar, and it gives your health care professional an indication of your blood glucose level over a three- to four-month period. An A1C at 5.6 percent, the percentage of sugar in your blood, is normal; a pre-diabetic range is between 5.7 and 6.4 percent. Anything over that indicates diabetes

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