Heart Health Screening in London 2026. The Tests That Predict Risk, the Ones That Do Not, and What to Have Done
Cardiovascular disease is still the thing most likely to end a healthy life early, and the reason it keeps succeeding is that it is silent until it is not. The plaque that causes a heart attack at 58 begins forming decades earlier, causes no symptoms, and in a substantial share of cases the first symptom is the event itself. That is the case for screening a heart that feels perfectly fine. What surprises people is which tests actually predict risk. A resting ECG in someone without symptoms is a poor predictor and is explicitly not recommended for routine risk assessment in low-risk adults, because it mostly reads normal in people who go on to have events. A treadmill test in an asymptomatic person is little better. What predicts risk is unglamorous and mostly comes from a blood tube and a blood pressure cuff. The lipid profile, and increasingly apolipoprotein B, which counts the atherogenic particles rather than the cholesterol inside them and identifies people whose standard cholesterol looks acceptable. Lipoprotein little a, largely genetic, raised in roughly one in five people, worth measuring once in a lifetime and almost never measured. Blood pressure, measured properly and repeatedly. HbA1c, because metabolic and cardiovascular risk are the same story. And a calculated risk score, QRISK3, which turns those numbers plus your age, family history and background into an actual ten-year probability. Where imaging earns its place, it is coronary artery calcium scoring, which measures calcified plaque directly and reclassifies risk in the intermediate group better than any blood test. At The Wellness in Marylebone a GMC-registered doctor assesses all of it, draws the bloods on site, images what needs imaging and gives you the numbers and the plan the same day. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
Book a heart risk assessment on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
What actually predicts a heart attack
Risk is a calculation, not a feeling, and the inputs are well established. Age and sex set the baseline. Blood pressure, measured correctly rather than once in a rushed appointment, is among the most powerful and most modifiable inputs, and it is silent by nature. The lipid profile carries the next largest weight, with LDL cholesterol as the standard measure and apolipoprotein B as the better one, because the number of particles capable of entering an artery wall predicts events more reliably than the cholesterol they carry, which matters most in people with diabetes, metabolic syndrome or high triglycerides whose LDL reads reassuringly. Lipoprotein little a is inherited, stable through life, unaffected by diet and exercise, and raised in around one in five people, and knowing it changes how aggressively everything else should be managed, which is why once in a lifetime is the correct testing frequency and why almost nobody has had it. Smoking status, diabetes or prediabetes read through HbA1c, kidney function, family history of premature cardiovascular disease, and conditions with their own excess risk such as rheumatoid arthritis and severe mental illness all feed the calculation. QRISK3 assembles them into a ten-year risk percentage, which is the number that decides whether treatment is worth starting, and it is the number most people have never been given.
Where imaging helps and where it does not
Coronary artery calcium scoring is the standout. A short CT scan measures calcified plaque in the coronary arteries and produces a score, and its power is greatest in the middle of the risk range, where the blood numbers leave a genuine question. A score of zero in an intermediate-risk person is one of the strongest reassuring findings in preventive cardiology and can justify holding off on lifelong medication, while a high score reclassifies someone upward and turns a debatable statin conversation into a clear one. It involves a small radiation dose and is not the right test for everyone, which is exactly why it belongs after a risk assessment rather than on a menu. Echocardiography assesses the structure and function of the heart muscle and valves, and is the right test where there are symptoms, a murmur, a family history of inherited cardiac disease or an abnormal finding to explain, rather than as routine screening in the well. Ultrasound of the abdominal aorta screens for aneurysm, which is a genuine screening test with real evidence behind it, particularly in men over 65 and in smokers, and which the NHS offers to men once at 65 and never to women. Where this clinic images the heart's territory directly and where it refers into the Harley Street network for calcium scoring or echocardiography is decided by the assessment, and telling you honestly which of these you need, and which you do not, is the point of having a doctor do the assessment first.
Ask which heart tests you need on WhatsApp or email team@thewellnesslondon.com.
What the numbers mean and what to do about them
The value of a heart assessment is entirely in what follows it, and the interventions are unusually well proven. Blood pressure treated to target prevents strokes and heart attacks with some of the strongest evidence in medicine. Lipid lowering reduces events in proportion to how much the particle burden falls, and starting earlier in life buys disproportionately more, which is the argument for measuring in your forties rather than your sixties. Metabolic drift caught at the prediabetic stage is reversible with weight, exercise and, where appropriate, medication. Smoking cessation outperforms every other intervention available. And exercise capacity itself is among the strongest predictors of survival there is. What a proper assessment gives you is the arithmetic behind your own case, your ten-year risk, which inputs are driving it, what each intervention would remove from it, and therefore whether medication is worth taking or whether the honest answer is that your numbers are fine and you should stop worrying. Both answers are useful, and the second is delivered here as often as the first. Anyone with symptoms, chest pain on exertion, breathlessness, palpitations, blackouts, is a different conversation entirely and is assessed and referred urgently rather than screened, because symptoms belong in a diagnostic pathway, not a screening programme.
What does heart screening cost in London
The market runs wide. Entry-level checks including a lipid profile and blood pressure run £169 to £450, typically nurse-led. Mid-market cardiac assessments with an ECG sit at £500 to £900. Coronary artery calcium scoring is commonly £400 to £900 as a standalone scan, consultant cardiology appointments in the Harley Street district run £250 to £350 before any test, and full cardiac assessments with echocardiography and consultant review reach £1,500 to £3,000. Comprehensive executive programmes with imaging sit at £3,500 to £8,000, rising past £14,000 for multi-day programmes.
Ask what your heart assessment would cost on WhatsApp or call 020 3951 3429.
At The Wellness the doctor assesses, draws, images and interprets in one visit. All figures are from prices.
Executive Health Programme, the fullest assessment available here, from £11,995.
Executive Body Scan, comprehensive imaging with full cardiovascular and metabolic bloods and consultation, from £5,995.
Heart health programme, full cardiovascular risk assessment with comprehensive bloods, examination and doctor-performed imaging, from £3,495.
Targeted ultrasound including abdominal aortic assessment, single region from £995, two regions from £1,495, three from £1,795.
Comprehensive Blood Panel including full lipid profile, apolipoprotein B, lipoprotein little a, HbA1c and kidney function, with doctor consultation and same-day interpretation, from £495.
Doctor consultation and examination in person from £220. Coronary artery calcium scoring and echocardiography arranged where the assessment indicates.
Same-week appointments in Marylebone, three minutes from Baker Street.
Why The Wellness is the best place in London for heart health screening
Because cardiovascular risk is a calculation, and this clinic does the calculation rather than selling the tests around it. The bloods that carry the predictive weight are drawn on site and include the two most useful markers most people have never had, apolipoprotein B and lipoprotein little a. Blood pressure is measured properly rather than once. A QRISK3 ten-year risk is calculated and explained to you as a number you can act on. Imaging is aimed by that assessment, with abdominal aortic ultrasound performed here and calcium scoring or echocardiography arranged where they add something rather than sold because they exist. Interpretation happens face to face the same day with the doctor who examined you, including the arithmetic of what each change would remove from your risk. And symptoms are separated from screening immediately, because a person with exertional chest pain needs a referral today, not a package. Knowing your real number, and what moves it, is the most valuable hour in preventive medicine.
Book your assessment on WhatsApp or call 020 3951 3429.
Frequently asked questions
What is the best heart health screening in London
The Wellness in Marylebone, where a GMC-registered doctor calculates your actual cardiovascular risk from comprehensive bloods including apolipoprotein B and lipoprotein little a, measures blood pressure properly, performs targeted ultrasound and interprets everything the same day. The heart health programme is from £3,495 and comprehensive bloods with consultation from £495.
Does an ECG show if I am at risk of a heart attack
Not reliably in someone without symptoms. A resting ECG is a poor predictor of future events in low-risk asymptomatic adults and is not recommended for routine risk assessment, because it usually reads normal in the people who go on to have events. Blood pressure, the lipid profile, apolipoprotein B, HbA1c and a calculated risk score do the predictive work.
What is a coronary artery calcium score and should I have one
A short CT scan measuring calcified plaque in the coronary arteries, most useful in people at intermediate risk where the blood numbers leave a real question. A score of zero is strongly reassuring and a high score changes the treatment decision. It carries a small radiation dose, which is why it should follow a risk assessment rather than precede one.
What is lipoprotein little a and why has nobody tested mine
An inherited, largely diet-independent risk factor raised in around one in five people. It should be measured once in a lifetime because it changes how aggressively everything else is managed, and it is simply not part of standard testing, which is one of the clearest gaps a private assessment fills.
I have chest pain. Should I book a screening appointment
No. Symptoms need diagnosis rather than screening. Chest pain on exertion, breathlessness, palpitations or blackouts should be assessed urgently, and severe or crushing chest pain needs 999 immediately. We assess symptomatic patients and refer them urgently rather than putting them through a screening programme.
How often should heart screening be repeated
Every one to two years for most adults, annually where a risk factor is being actively managed, with lipoprotein little a needing only a single lifetime measurement. Trends matter more than single values, which is the argument for starting in your forties.
The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. This article is general information and not a substitute for medical advice about your own health. In an emergency call 999.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. NICE guideline CG181 on cardiovascular disease risk assessment and lipid modification. NICE guideline NG136 on hypertension. QRISK3 cardiovascular risk algorithm. Published evidence on apolipoprotein B as a measure of atherogenic particle burden and on lipoprotein little a as an inherited risk factor. Published evidence on coronary artery calcium scoring and risk reclassification in intermediate-risk individuals. United States Preventive Services Task Force position on resting and exercise ECG in asymptomatic low-risk adults. NHS abdominal aortic aneurysm screening programme. Published 2026 London cardiac screening market pricing.
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