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How often should you get a CIMT test? Find out the ideal timing based on your heart risk factors.
You may feel healthy, but problems can build up over time without warning signs. That’s why early testing matters. But what kind of test should you get? And when?
Experts say the answer depends on your health and risk factors. If you’re healthy, testing can wait. But if you have certain risks—like high blood pressure or a family history—you may need to start sooner.
In this article, you’ll learn when to get tested, how often, and what doctors recommend based on your risk level.
When should someone get tested for early signs of heart disease?
It depends on whether they have risk factors or not—let’s look at what experts recommend for healthy people and those at higher risk.
For people without any known risk factors, a baseline Carotid Intima-Media Thickness (CIMT) test is suggested at age 45. This age is considered an appropriate starting point for early detection of atherosclerosis before any symptoms appear.
Individuals in good health can wait until this age to get their first CIMT scan. The test helps identify whether there are early signs of inflammation or plaque building up inside the carotid arteries, which are the arteries in the neck that supply blood to the brain.
If the CIMT test result is normal and no plaque is seen, there is no need for frequent retesting. It is recommended to repeat the test every three years. This interval is considered safe because a normal result in someone without risk factors typically means the arteries are not currently undergoing significant disease changes.
However, if new symptoms or risk factors develop later, earlier testing might be needed.
People who have risk factors for heart disease should not wait until age 45 to get tested. The recommendation is to get a CIMT test earlier. This is because atherosclerosis, which is the buildup of plaque in the artery walls, can start silently and progress over time without causing any symptoms. Early testing can detect disease that would not be picked up by routine cholesterol tests or even stress tests.
The most common risk factors include:
Autoimmune diseases such as lupus, rheumatoid arthritis, and inflammatory bowel disease also increase the risk. People with chronic unhealthy lifestyle habits, such as poor diet and lack of exercise, fall into this higher-risk category as well.
About 50% of men and 64% of women who died suddenly from coronary vascular disease had no previous symptoms. Even more striking, up to 50% of people who died from heart attacks or strokes had “normal” lipid profiles. These numbers show that relying only on cholesterol tests is not enough.
That’s why earlier CIMT testing is valuable for anyone with risk factors—it can catch dangerous plaque even when other tests appear normal.
Now, how often should CIMT testing be repeated? It depends on what the first test shows and whether there are any new health concerns or risk factors.
Once an abnormal CIMT result is identified—meaning early signs of plaque or artery wall thickening—repeat testing is advised every 12 months.
Annual CIMT scans allow providers to watch for changes in the artery walls over time. If the thickness increases or new plaque appears, it may signal that the current treatment isn't enough. In that case, more aggressive strategies may be needed to reduce risk.
This one-year interval isn't just about watching for worsening. It also helps track whether a plan is working.
For example, if a patient is taking medication to lower cholesterol or blood pressure, or following a stricter diet and exercise plan, the next scan can confirm whether those steps are helping to slow or reverse artery changes.
In some cases, testing might be repeated sooner—at the six-month mark. This can be especially useful after starting new treatments aimed at lowering cardiovascular risk. Improvement can sometimes be detected in that short time.
A six-month scan may show less inflammation or reduced plaque size. That kind of early progress gives helpful confirmation that changes are making a difference. It also allows the healthcare provider to adjust the treatment faster if needed.
For patients who have already had a CIMT scan that shows no abnormal findings, and who do not have new risk factors or symptoms, the test does not need to be done often.
A three-year interval in these cases is recommended. This gap gives enough time for any meaningful changes to develop in the artery walls while avoiding unnecessary repeat scans.
Since CIMT is a structural test—not a day-to-day measure like blood pressure—it’s safe to check less frequently if everything looks normal and remains stable.
Experts from the American Society of Echocardiography (ASE) advise against routine repeat CIMT testing in people who are asymptomatic and whose test results do not meet specific thresholds.
In particular, serial measurements are not recommended unless the carotid intima-media thickness reaches 1.5 mm or greater, which the panel defines as a sign of diffuse-type plaque. This value marks a shift from general thickening to a clinically significant atherosclerotic lesion.
This guidance is rooted in the concern that low CIMT values—especially those below the 1.5 mm cutoff—can reflect natural aging or non-atherosclerotic changes, like medial thickening from high blood pressure, rather than actual plaque. In such cases, repeating the test adds little value for cardiovascular risk assessment. Performing unnecessary follow-ups may lead to confusion or misinterpretation, especially when no plaque is present.
For CIMT values that do meet the ≥1.5 mm threshold, the ASE consensus acknowledges these cases as plaque equivalents. This includes both protuberant and diffuse lesions of that size or greater. These measurements fall under Grade II or Grade III in their standardized grading system.
In these situations, serial assessments can be more appropriate, especially if they help monitor the effectiveness of treatment or the progression of the disease.
If you're healthy and have no major risks, age 45 is the right moment to check your arteries with a CIMT scan. But if you have risk factors—like high blood pressure, diabetes, or a family history—it’s smarter to test earlier. Heart disease doesn’t always show up in blood tests or cause symptoms before it strikes. Regular scans are only needed if something concerning shows up. Otherwise, testing every few years is enough.
So, know your risks, talk to your doctor, and don’t wait for symptoms to take the first step.
