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Blood tests for heart disease in the family What to check when it runs in your family

If a parent, brother or sister had heart disease young, US guidelines count that toward your own risk, even when a risk calculator puts yours low.1 Some of what runs in families shows up in a blood test, but not all of it on a standard cholesterol test. Here’s what’s worth testing, what the results can and can’t tell you and what to do next.

5 tests $40.65 Results in 2 to 3 days

The short answer

If heart disease runs in your family, five blood tests check for the risks that are often inherited: very high cholesterol and a high Lp(a). They also count the particles that build plaque and check inflammation and blood sugar, which add to that risk.1 Ask for a lipid panel, Lp(a), ApoB, hs-CRP and HbA1c.

Before you go
Fast for 12 hours if you can; water is fine. The five tests still work if you don’t, but when heart disease came early in your family, US guidelines recommend a fasting cholesterol test and Labcorp prefers one.1,5 The Heart Health panel needs fasting.
If one is high
Most results are about your risk over the years ahead, not this week. The exception is triglycerides of 500 mg/dL or more, which can inflame the pancreas, so see a clinician soon.1 A very high LDL or a high Lp(a) also means your parents, brothers, sisters and children should be tested.1
Call 911 instead
For chest pain or pressure, shortness of breath, a drooping face, a weak arm or slurred speech. Don’t wait for a blood test.6 All the signs
What it costs
$40.65 for all five, from one blood draw. That’s the whole cost, and it’s HSA and FSA eligible.
The family-history heart tests
$40.65 · 5 tests, one draw
Order

What the five tests look for

The first two look for cholesterol problems you can inherit, and the third counts the particles that build plaque. The last two check inflammation and blood sugar, which add to the risk. All five come from one blood draw.

  1. 01

    Inherited high cholesterol

    Lipid panel test

    Your LDL, HDL and triglycerides. An LDL of 190 or more can be a sign of familial hypercholesterolemia, which about 1 in 250 to 300 people inherit. As many as 90% of them don’t know they have it.1

    More likely if a relative had a heart attack young. Up to 1 in 5 adults who have an early heart attack have this pattern of very high cholesterol.1

  2. 02

    An inherited risk cholesterol tests miss

    Lp(a) test

    Lp(a) is a particle set mostly by your genes, and a high level raises heart risk on top of your LDL. About 1 in 5 people have one. A standard cholesterol test leaves it out, and you usually only need it once.1

    More likely if a parent, brother, sister or child has a high Lp(a), or heart disease came early in your family.1

  3. 03

    Too many plaque-building particles

    ApoB test

    ApoB counts the particles that build plaque, which a standard cholesterol test doesn’t. When it and your LDL disagree, ApoB is the more accurate guide to your risk.1

    More likely to disagree with your LDL if you have high triglycerides, diabetes or extra weight.1

  4. 04

    Low-level inflammation

    hs-CRP test

    Inflammation adds to heart risk: 2 mg/L or more on two tests can tip a borderline decision about a statin.1 A cold or other recent illness pushes it up, so test once you’ve recovered.2

    More likely if you smoke, carry extra weight or have an inflammatory condition such as rheumatoid arthritis.2

  5. 05

    High blood sugar

    HbA1c test

    Your average blood sugar over the past two to three months. Diabetes raises heart risk enough that US guidelines recommend a statin for adults 40 to 75 who have it, whatever their other risks.1

    More likely if diabetes runs in your family too, or you carry extra weight.4

What else matters for your heart?

A family history isn’t only genes. Families share habits too, and high blood pressure and smoking add to whatever risk you inherit. No blood test shows those, or plaque that’s already built up. Here’s what to check, and what to do about each.

The details of your family history

US guidelines count a parent, brother or sister whose heart disease or stroke started young: before 55 in men, or before 65 in women.1

Ask who had it, what it was, how old they were and whether anyone had very high cholesterol. Then tell your clinician.

Blood pressure

High blood pressure adds to heart risk and rarely causes symptoms, so many people who have it don’t know.7

Check it at home or at a pharmacy. An average of 130/80 or higher over several readings counts as high.7

Smoking

Quitting helps quickly. Heavy smokers who had quit within the past five years had about 40% lower risk of a heart attack, stroke, heart failure or death from heart disease than those still smoking.8

If you smoke, ask a clinician for help quitting.

Plaque that’s already there

Blood tests show the risk; a heart scan shows plaque directly. A calcium score is the usual first scan. A CT angiogram also shows soft plaque, which a calcium score can miss.1

If the decision about a statin is close, ask whether a scan would help. Guidelines use one from 40 in men and 45 in women.1 About Picardo’s heart scan

Call 911 right away for any of these

  • Chest pain, pressure, squeezing or discomfort that lasts more than a few minutes or comes back
  • Pain in one or both arms, the back, neck, jaw or stomach
  • Shortness of breath, with or without chest pain
  • A cold sweat, nausea or lightheadedness
  • Sudden loss of balance or changes in vision
  • A drooping or numb face, a weak or numb arm or slurred speech
  • Someone collapses and isn’t breathing normally. Call 911 and start CPR.

These are the American Heart Association’s warning signs of a heart attack, stroke or cardiac arrest. With stroke signs, call even if they go away.6

How to get tested, and what it costs

Order the five tests on their own, or get them inside the Heart Health panel, which adds insulin, kidney, liver and thyroid tests and more. The five tests need one blood draw; the panel also needs a urine sample.

The family-history heart tests
$40.65

The five tests on this page, from one blood draw. Fast for 12 hours first if you can.

Best if you want to know what you might have inherited.

Order the five tests
Heart Health
$150.90

The same five checks, with an advanced cholesterol test that also counts your LDL particles, plus insulin, kidney, liver and thyroid tests, a blood count, vitamin D, B12, folate, magnesium, uric acid and ApoA1. Women also get a pregnancy test, and men a PSA test. 17 tests. Fast for 12 hours first.

Best if you also want insulin resistance, your kidneys and your thyroid checked, since each can affect heart risk.

Order the panel
  1. 01

    Order online

    Pick the five tests or the Heart Health panel. The price is the whole cost, and you can pay with an HSA or FSA card.

  2. 02

    Blood draw

    Fast for 12 hours first; water is fine. The panel needs it, and it’s best for the five tests too. Eat as you usually do in the weeks before. If you take biotin, stop it 3 days before. Go to any Labcorp location for free, or have blood drawn at home for $75.

  3. 03

    Get your results

    In the Picardo app in 2 to 3 days, with an explanation of each one. Ask Picardo what they mean, and book a physician follow-up if you want one.

Already have results?

My LDL was normal

Good, but it doesn’t rule out inherited risk. LDL can’t show your Lp(a), and ApoB can be high while LDL looks fine.1 Your family history also counts toward your risk on its own.1

Check your LDL number

My LDL was 190 or more

US guidelines recommend checking for other causes first, such as an underactive thyroid, then cholesterol-lowering medicine, starting with a statin, without using a risk calculator. Ask whether it could be familial hypercholesterolemia. If it might be, your relatives should be tested too.1

My Lp(a) is high

US guidelines count 125 nmol/L or more as raising your risk. Diet and exercise barely move it, and statins don’t lower it, so the aim is to keep your LDL, blood pressure and blood sugar lower than you otherwise would. Ask your parents, brothers, sisters and children to get tested once.1

Check your Lp(a) number

My ApoB is higher than my LDL suggests

Go by the ApoB. When the two disagree, it’s the more accurate guide to your risk. It happens most with high triglycerides or diabetes.1 Ask a clinician whether your target or treatment should change.

Check your ApoB number

My hs-CRP was high

Test again in about 2 weeks, once you’re well: a recent cold or other illness can push it up.2 It’s common, too. About half of US adults have 2 mg/L or more.3 If yours stays there, it can tip a borderline decision toward a statin.1 Your Labcorp report may call 1 to 3 mg/L average; US guidelines start counting it at 2.1

Check your hs-CRP number

Ask Picardo about your results. The app explains what each one means, and a physician can follow up if you want.

Questions people ask

What blood tests should I get if heart disease runs in my family?

A lipid panel and Lp(a), which US guidelines recommend for every adult, with Lp(a) at least once.1 ApoB, hs-CRP and HbA1c add detail on plaque-building particles, inflammation and blood sugar.1,3 A standard cholesterol test leaves out Lp(a) and ApoB, so ask for them by name.

What counts as a family history of heart disease?

US guidelines count a parent, brother or sister whose heart disease or stroke started before 55 in men, or before 65 in women. It counts toward your risk even if a risk calculator puts yours low.1 Relatives who had it later aren’t part of that definition, but mention them to your clinician, along with anyone who had very high cholesterol.

Do I need to fast for these tests?

Not strictly, but it’s best if heart disease came early in your family: US guidelines recommend a fasting cholesterol test then, and Labcorp prefers one.1,5 Fast for 12 hours if you can: water is fine, but skip food, coffee and tea. Lp(a), ApoB, hs-CRP and HbA1c don’t need it.1,2,4

How often should I get tested?

Lp(a) usually just once, since it barely changes over your life.1 For cholesterol, US guidelines suggest a test every 5 years from age 19, and more often as you get older or if you have other risk factors.1

Should my children be tested?

Yes, if heart disease came early in your family. US guidelines say a child whose parent, grandparent, aunt or uncle had early heart disease, very high cholesterol or familial hypercholesterolemia can have a cholesterol test from age 2. If you have a high Lp(a), your children should have an Lp(a) test too. Otherwise, every child should have a cholesterol test once between 9 and 11.1

Should I get a calcium score instead?

It answers a different question. A calcium score shows plaque that’s already there; blood tests show the risk that builds it, including what you inherit. Guidelines use a calcium score when a statin decision is unclear, from 40 in men and 45 in women.1 A score of zero is less reassuring if several close relatives had heart disease young, and it isn’t used to rule out treatment if you have familial hypercholesterolemia.1

Can I get these tests without seeing a doctor first?

Yes. Order them online, get a blood draw at a Labcorp location or at home, and your results arrive in the Picardo app in 2 to 3 days. You can book a physician follow-up if you want to talk them through.

What happens if a result is off?

The app explains what it means and what usually comes next. Most results are about your risk over the years ahead, not this week. The exception is triglycerides of 500 mg/dL or more, which can inflame the pancreas, so see a clinician soon.1 A high LDL or ApoB responds well to treatment: statins lower LDL by 30% to 50% or more.1 A high Lp(a) can’t be lowered much yet, so the aim is to keep everything else low.1 A physician can follow up if you want one.

Sources

  1. 1 Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of dyslipidemia: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153(17):e1154–e1276. doi.org/10.1161/CIR.0000000000001423
  2. 2 Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107(3):499–511. doi.org/10.1161/01.CIR.0000052939.59093.45
  3. 3 Mensah GA, Arnold N, Prabhu SD, Ridker PM, Welty FK. Inflammation and cardiovascular disease: 2025 ACC scientific statement: a report of the American College of Cardiology. J Am Coll Cardiol. 2026;87(11):1381–1404. doi.org/10.1016/j.jacc.2025.08.047
  4. 4 American Diabetes Association Professional Practice Committee for Diabetes. 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S27–S49. doi.org/10.2337/dc26-S002
  5. 5 Labcorp. Lipid Panel (303756). Labcorp test menu. Accessed October 28, 2026. www.labcorp.com/tests/303756/lipid-panel
  6. 6 American Heart Association. Heart attack, stroke and cardiac arrest symptoms. Accessed October 28, 2026. www.heart.org/en/about-us/heart-attack-and-stroke-symptoms
  7. 7 Jones DW, Ferdinand KC, Taler SJ, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025;152(11):e114–e218. doi.org/10.1161/CIR.0000000000001356
  8. 8 Duncan MS, Freiberg MS, Greevy RA, et al. Association of smoking cessation with subsequent risk of cardiovascular disease. JAMA. 2019;322(7):642–650. doi.org/10.1001/jama.2019.10298

Updated 4 Nov 2026.

This is general health information, not medical advice: talk to your clinician about your results and before changing any treatment.