Laboratory Tests for Annual Physical Examinations
Core Laboratory Tests for All Adults
- The American College of Cardiology recommends complete blood count (CBC) with differential to screen for anemia, infection, and blood disorders in all adults 1, 2
- Comprehensive metabolic panel (CMP) is recommended to assess kidney function, liver function, and electrolyte balance in all adults 1, 2
- Lipid profile, including total cholesterol, LDL, HDL, and triglycerides, is recommended to assess cardiovascular risk in all adults 1, 2
- Hemoglobin A1C is recommended to screen for diabetes and prediabetes in all adults, with a strength of evidence of high 1, 3
- Urinalysis with albumin-to-creatinine ratio is recommended to screen for kidney disease and urinary tract infections in all adults 1, 3
- Blood pressure measurement is recommended at every visit for all adults 1, 3
Age and Risk-Based Screening
Diabetes Screening
- Annual hemoglobin A1C testing is recommended for adults with BMI ≥25 kg/m² with one or more risk factors, with a strength of evidence of moderate 1, 3
- Yearly testing is recommended for patients with prediabetes (A1C 5.7-6.4%) 1
- Testing is recommended beginning at age 35 and repeating every 3 years if normal for all other adults 1
Cardiovascular Screening
- Annual blood pressure check is recommended for all patients, with a strength of evidence of high 1, 3
- Fasting lipid profile is recommended every 6-12 months for all patients 1
- Abdominal ultrasonography is recommended once for men aged 65-75 years who have ever smoked 1
Special Considerations for Older Adults
- Thyroid-stimulating hormone (TSH) testing is recommended for women and older adults, with a strength of evidence of moderate 1, 3
- Bone densitometry is recommended for postmenopausal women and men age ≥50 years 1
- Functional performance assessment is recommended for adults ≥65 years, with a strength of evidence of low 3
- Screening for cognitive impairment is recommended in older adults with risk factors, with a strength of evidence of moderate 1, 3
Medication-Specific Monitoring
- Vitamin B12 levels are recommended for patients on metformin, with a strength of evidence of high 1, 3
- Serum potassium levels are recommended for patients on ACE inhibitors, ARBs, or diuretics, with a strength of evidence of moderate 1, 3
Special Population Considerations
Patients with Diabetes
- More frequent monitoring of hemoglobin A1C (typically every 3-6 months) is recommended, with a strength of evidence of high 3
- Annual screening for diabetes complications including nephropathy (urine albumin-to-creatinine ratio), retinopathy (eye exam), and neuropathy (foot exam) is recommended, with a strength of evidence of moderate 3
Patients with Chronic Kidney Disease
- More frequent monitoring of electrolytes, BUN, and creatinine is recommended, with a strength of evidence of moderate 3
- Monitoring for anemia and metabolic bone disease is recommended, with a strength of evidence of low 3