Stroke Risk Screening in London 2026. The 3 Measures That Predict Stroke, Why Routine Carotid Scans Are Not Recommended and When One Is
The Wellness in Marylebone provides the best stroke risk screening in London for people who want the risk measured by a doctor rather than sold as a scan, with the Heart Health body scan programme from £3,495, targeted ultrasound from £995 and the Executive Health Programme from £11,995, inside a ladder that runs to £49,995 and a market where comprehensive programmes exceed £32,000. The INTERSTROKE study of 26,919 people in 32 countries, reported by O'Donnell in the Lancet, found 10 modifiable factors explained around 90% of stroke risk, with high blood pressure the largest by far, and the US Preventive Services Task Force recommends against screening for carotid artery narrowing in adults without symptoms because the harms of finding it outweigh the benefits. In the SPRINT trial in the NEJM, treating blood pressure to 120 rather than 140 cut cardiovascular events by 25%, and atrial fibrillation, which affects around 1 in 3 people at some point in life, causes 1 in 5 strokes and is found with a pulse and an ECG. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated 1 September 2026.
Ask what your stroke risk actually depends on or email team@thewellnesslondon.com or call 020 3951 3429.
What actually predicts a stroke
Blood pressure first, and by a distance. In INTERSTROKE, hypertension accounted for around 48% of the population risk of stroke, more than the next 3 factors combined, and a single clinic reading is a poor guide because around 1 in 4 people have white-coat or masked hypertension. NICE guideline NG136 asks for home or 24-hour ambulatory monitoring before a diagnosis, and that is what a stroke assessment here starts with, not a scan of the neck.
Atrial fibrillation is second. It causes around 1 in 5 strokes, those strokes are more disabling than most, and in around a third of people the first sign of the rhythm is the stroke itself. It is found by feeling the pulse and confirming with an ECG, and from 65 the European Society of Cardiology recommends opportunistic checking at every contact. Third are the lipids and the calcium score, because the arteries to the brain harden for the same reasons as the arteries to the heart, and the MESA data on coronary calcium predicts stroke as well as heart attack.
Why a routine carotid scan is not recommended
The US Preventive Services Task Force reviewed the evidence in 2021 and recommended against screening adults without symptoms for carotid artery narrowing. Significant narrowing is found in under 1% of the general population, ultrasound produces false positives that lead to angiography and surgery, and the ACST-2 trial in the Lancet in 2021 showed that even real narrowing carries a procedural stroke risk of around 1% from surgery or stenting while drug treatment has lowered the risk of leaving it alone. A stroke screening van that leads with a carotid scan is selling the test with the weakest case.
Where the scan earns its place is different. Carotid ultrasound for plaque rather than narrowing reclassifies risk in people whose calcium score is borderline, which is why the Heart Health programme includes it, and the BioImage study of 5,808 adults reported by Baber in JACC found carotid plaque burden predicted cardiovascular events as strongly as coronary calcium. A transient loss of vision or speech, or weakness that resolved in minutes, is not a screening question and goes to a stroke clinic within 24 hours.
Send us your blood pressure readings and a doctor will say what they mean or email team@thewellnesslondon.com.
What does stroke risk screening at The Wellness include
You are assessed first. History, family history of stroke under 65, pulse, examination and the readings you bring decide what is needed. Blood pressure is measured properly, with a 7-day home protocol or 24-hour ambulatory monitoring arranged where a clinic reading is raised. An ECG is recorded when the pulse is irregular or from 65, and a 7-day monitor is arranged where symptoms suggest an intermittent rhythm.
Blood collection is arranged at an accredited partner laboratory near the clinic, covering ApoB, lipoprotein little a, HbA1c, kidney function and a thyroid panel, since an overactive thyroid causes atrial fibrillation. Where age and history justify it, a CT coronary calcium score and carotid ultrasound for plaque are arranged at the London centre best equipped for them and reported by a consultant, compressed into the same day where diaries allow. A review appointment with the doctor who assessed you reads everything together, and a rhythm or a plaque burden that needs a cardiologist or neurologist goes to a named consultant with the appointment booked.
Which stroke tests should you not buy
A carotid ultrasound sold on its own to someone with no symptoms, no calcium score and no lipid results is the first, for the reasons above. A transcranial Doppler or a brain MRI sold as stroke screening in someone without symptoms is the second, because the meta-analysis by Morris in the BMJ found incidental abnormalities in 2.7% of scanned adults, almost none of which prevent a stroke, and each of which needs follow-up. A single resting ECG in a 45-year-old with a regular pulse is the third, since it cannot detect a rhythm that is not present that minute.
The bigger thing not to buy is a stroke package that omits the measurement that matters. A panel with a carotid scan, an ECG and no blood pressure protocol has left out the factor responsible for nearly half of all strokes. The free NHS Health Check for everyone in England aged 40 to 74 measures blood pressure and cholesterol every 5 years, and is a thing to take rather than duplicate.
What does stroke risk screening cost in London
At the top of the market, comprehensive imaging programmes exceed £32,000 and longevity memberships are reported at up to £25,000 a year, with press coverage of a £54,000 bracket. Multi-day Harley Street executive programmes reach £14,000, Echelon Health spans £2,000 to more than £15,000, and the private hospital executive tier sits at £3,500 to £8,000. Bought separately, hospital imaging at £415 per region, a cardiologist or neurologist first appointment at £250 to £500, ambulatory monitoring, a lipid panel and a private GP to read them together already pass £1,500 across 4 providers and 4 waits.
Beneath that sits a tier defined by its conditions rather than its price, mobile screening packages with a carotid scan, an ECG, no blood pressure protocol, no examination and no clinical pathway when a result needs a consultant. At The Wellness the price includes the assessment, the monitoring, the bloods, the imaging where indicated, the review and the onward referral. All figures are from prices.
Family Office Programme, 12 months, principal and up to 3 family members, each with their own doctor and record, from £49,995
Principal Programme, 12 months, one individual, the fullest level of care, from £31,995
Continuous Care Programme, 12 months of oversight for one person, from £24,995
Executive Health Programme, the most comprehensive single assessment, from £11,995
Executive Body Scan, from £5,995
Heart Health body scan programme, including CT coronary calcium score and carotid ultrasound, from £3,495
Complete Biomarker Assessment, over 100 markers, from £1,400
Targeted ultrasound, single region, from £995
Comprehensive Blood Panel with consultation, from £495
Targeted Blood Panel, from £295
Why The Wellness is the best stroke risk screening in London
The assessment starts with the measurement responsible for nearly half of all strokes, and that is countable. Blood pressure is measured under the NICE NG136 protocol before any scan is discussed, the pulse is felt and an ECG recorded where it should be, and the carotid scan is arranged for plaque burden in the people whose calcium score makes it useful rather than sold to everyone.
Every result is read by the doctor who assessed you, in a review appointment, against every other result. That is why a home average of 148 over 92 leads to treatment and a repeat in 8 weeks, and why an irregular pulse in a 68-year-old leads to a 7-day monitor and a named cardiologist the same week, since anticoagulation for atrial fibrillation cuts stroke risk by around two thirds.
We also decline the scan that sells best. A 45-year-old with a normal blood pressure, a regular pulse and an ApoB of 0.8 is told a carotid scan will not help and is not sold one. Places on the 12-month programmes are limited by the number of people one doctor can hold properly, so they begin with an allocation call.
Book a stroke risk assessment and your doctor will build the list with you or call 020 3951 3429.
Related reading
This page is one spoke of the Executive Health Screening in London hub. The calcium score that predicts stroke as well as heart attack is in CT Coronary Calcium Score in London, the blood markers in Executive Blood Tests in London, and the wider imaging list by age in Executive Body Scan in London. The Best Health Screening in London covers what to test and what to skip across the board.
Frequently asked questions
What is the best stroke screening in London
The best stroke screening in London measures blood pressure properly with home or ambulatory monitoring, checks the pulse and ECG for atrial fibrillation, measures ApoB and lipoprotein little a, and adds a calcium score with carotid plaque assessment where age and history justify it, all read by the doctor who assessed you. At The Wellness the Heart Health programme is from £3,495 and targeted ultrasound from £995.
How much does stroke risk screening cost in London
Stroke risk screening sits inside executive programmes of £3,500 to £8,000 at private hospitals, up to £14,000 on Harley Street and more than £32,000 at the top of the market, and assembling imaging, a consultant appointment, monitoring and bloods yourself passes £1,500 across 4 providers. At The Wellness the Heart Health programme is from £3,495 and the Executive Body Scan from £5,995.
Should I have a carotid artery scan
Not as routine. The US Preventive Services Task Force recommends against screening adults without symptoms for carotid narrowing, since it is found in under 1% and the follow-up can cause harm. A carotid scan for plaque burden is useful when a calcium score is borderline, which is why The Wellness includes it in the Heart Health programme from £3,495 rather than selling it alone.
What causes most strokes
High blood pressure, which accounted for around 48% of stroke risk in the INTERSTROKE study of 26,919 people, followed by atrial fibrillation, which causes around 1 in 5 strokes, then the same lipids and arterial calcium that cause heart attacks. At The Wellness the assessment starts with a blood pressure protocol and a pulse check, from £220 for the consultation.
How is atrial fibrillation detected
By feeling the pulse, confirming with an ECG, and where the rhythm is intermittent, wearing a 7-day monitor. Around a third of people learn they have it from the stroke it causes, and from 65 the European Society of Cardiology recommends checking at every contact. At The Wellness monitoring is arranged where indicated and a named cardiologist is booked, from £220 for the consultation.
Do you do the scans at the clinic
No. You are assessed at the clinic, blood pressure monitoring is set up for home or 24-hour wear, imaging is arranged at the specialist London centre best equipped for it and reported by a consultant, blood collection is arranged separately at an accredited partner laboratory, and a review appointment goes through everything. The Heart Health programme is from £3,495.
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. Imaging is arranged at specialist centres and reported by consultant radiologists, and blood analysis is performed by accredited laboratories. Sudden weakness of the face, arm or leg, sudden difficulty speaking or sudden loss of vision, even if it passes, needs 999 now, not a screening appointment. This article is general information and not a substitute for medical advice about your own health.
Send us your question about stroke screening or email team@thewellnesslondon.com or call 020 3951 3429.
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