Your family tree and free risk calculators can show you where to start

Key takeaways

• About 48% of U.S. adults had high blood pressure in 2021–2023, and about 4 in 10 of them had never been told they had it, according to CDC’s health statistics center².
• CDC estimates that 115.2 million U.S. adults have prediabetes, and about 8 in 10 people with prediabetes are unaware of it³⁴.
• A written family history, with each relative’s conditions and age at diagnosis, is one of the cheapest risk checks there is, and CDC names four patterns that call for a clinician’s attention⁶.
• Free tools such as the American Heart Association’s PREVENT calculator, CDC’s one-minute prediabetes test and NCI’s breast cancer risk tool estimate risk for people like you, not your personal fate⁴⁵⁹¹².
• Score each possible change for impact, readiness and urgency, but let a clinician take the lead when a number such as blood pressure is far out of range¹¹.

In March 2024, the actress Olivia Munn told her Instagram followers that she had been diagnosed with breast cancer the year before¹. What drew attention was how it was found. Her mammogram had been normal¹.

Her physician, Thaïs Aliabadi, had calculated Munn’s lifetime risk of breast cancer, a statistical estimate based on her history and risk factors. The answer was 37%¹. For a typical woman in her 40s, the figure is about 12%, according to Johns Hopkins oncologist Otis Brawley¹.

Munn was 43. That high number led to an MRI, then an ultrasound, then a biopsy¹.

One celebrity’s story proves little about you. Experts quoted in the same CNN report said online risk tools should start a conversation with a clinician, not finish it¹.

Still, it shows how a risk number can change what deserves attention first. Most people pick priorities without knowing their numbers at all.

This guide shows how to rank what to work on, using your family history, a few tested free tools, the screenings for your age and the problems that bother you most.

Two of the most common risks give no warning

Ask people what to work on, and they often name what they can feel: low energy, a stiff back, a few extra pounds. Those matter, but some of the biggest risks make no noise.

High blood pressure is the clearest case. In national survey data from August 2021 to August 2023, 47.7% of U.S. adults had high blood pressure, CDC’s National Center for Health Statistics reported².

Only about 1 in 5 of them had it under control, below 130/80. About 4 in 10 had never been told by a doctor or other health professional that they had it².

Blood sugar works the same way. CDC’s National Diabetes Statistics Report, updated in September 2026, estimates that 115.2 million U.S. adults have prediabetes, meaning blood sugar is above normal but not yet in the diabetes range³.

About 8 in 10 adults with prediabetes don’t know it, CDC says⁴. Among adults who already have diabetes, 27.6%, about 11 million people, haven’t been diagnosed³.

So the first step in setting priorities is finding out what’s true about you.

Your family tree is the cheapest risk check you’ll ever do

Your relatives’ health is a preview, not a verdict. CDC’s Office of Public Health Genomics calls family history part of a lifelong wellness plan⁶.

CDC suggests gathering facts about your parents, brothers and sisters, children, grandparents, aunts and uncles, and nieces and nephews⁶. For each one, note major health conditions, the age each problem began, and the cause and age of death. Your family’s ethnic background matters, too⁶.

Family get-togethers are a natural time to ask. If you can, fill gaps with old medical records or a relative’s death certificate⁶.

A free federal tool can keep it organized. My Family Health Portrait grew out of the U.S. Surgeon General’s Family History Initiative, which began in November 2004; the web tool followed a year later⁷. You can print what you build and share it with relatives and your clinician⁷.

The tool has changed hands over the years. As of 2026, NIH’s genome institute links to a version managed by the National Cancer Institute⁷⁸. It says what you type isn’t sent to government servers; you save the file yourself⁸.

Don’t worry if you can’t fill in every line. CDC notes that you can be at risk even without a known family history, because habits, your own medical history and relatives you know little about all play a part⁶. A worrying history isn’t destiny, either. You can’t change your genes, but not smoking, staying active and eating well still lower your risk⁶.

Three free calculators, and what each one can’t tell you

A risk calculator turns your facts into a number: the chance that people like you will develop a condition within a set time. Here are three free ones.

Tool	Who it’s for	What you need	What it gives you
AHA PREVENT	Adults 30 to 79 without heart disease	Blood pressure, cholesterol, kidney function, body mass index, diabetes and smoking status, your medicines; ZIP code optional	10-year and 30-year risk of heart attack, stroke and heart failure, plus a “heart age”910
CDC Prediabetes Risk Test	Adults	Facts you already know, such as age, height and weight; no lab results	A score; 5 or higher means significant risk5
NCI Breast Cancer Risk Assessment Tool	Women 35 to 85	Age, race and ethnicity, biopsy history, reproductive history, breast cancer in a mother, sister or daughter	5-year and lifetime risk, to age 90, of invasive breast cancer12

PREVENT, the American Heart Association’s newest heart risk calculator, was developed in 2023 and built from data on more than 6.5 million U.S. adults¹⁰. Unlike older tools, it also estimates heart failure and counts kidney and metabolic health⁹. It’s designed for clinicians to use with patients, so bring your results to an appointment¹⁰.

Younger adults should check the 30-year estimate. A 2024 study in the journal Hypertension looked at adults with high blood pressure, and plenty who seemed low risk over 10 years faced high odds over 30⁹. Northwestern cardiologist Sadiya Khan, who led the team that built PREVENT, makes the same point: at 35, the next decade may not worry you much⁹.

The prediabetes risk test takes about a minute at DoIHavePrediabetes.org⁴. The American Diabetes Association created the first version in 1993, and it was checked against CDC data⁵. A high score is a reason to get a blood test, because only a blood test can diagnose prediabetes⁵.

NCI’s breast cancer tool, often called the Gail model, has limits that matter. It can’t accurately estimate risk for women with a BRCA1 or BRCA2 gene change, or for women who have had breast cancer, DCIS or LCIS¹². Its first questions also screen out women who had chest radiation for Hodgkin lymphoma¹². It may also underestimate risk in two groups: Black women with past biopsies, and Hispanic women born in another country¹². Women with several affected relatives may need a different tool¹¹².

Every calculator shares one more limit, and NCI spells it out: a risk estimate can’t tell you which woman will get cancer. Some women with high scores never do, while some with lower scores do¹².

Screenings for your age set the floor

Some priorities apply to nearly everyone of a certain age. The U.S. Preventive Services Task Force (USPSTF), an independent expert panel, grades screenings by the strength of evidence. Here are some of its top-graded (A and B) recommendations¹³:

Screening or service	Who it’s for
Blood pressure	Adults 18 and older not already diagnosed
Prediabetes and type 2 diabetes	Adults 35 to 70 with overweight or obesity
Colorectal cancer	Adults 45 to 75
Breast cancer (mammogram)	Women 40 to 74, every two years
Lung cancer	Adults 50 to 80 with a 20 pack-year smoking history who smoke now or quit within 15 years
Statin to prevent heart disease	Adults 40 to 75 with at least one risk factor and a 10-year risk of 10% or more
Depression	Adults, including during and after pregnancy
Anxiety	Adults 64 and younger
Unhealthy alcohol use	Adults 18 and older

If you’re overdue for one of these, catching up may be your first priority, because the result can reshuffle everything else. Our article on preventive care explains which of these most health plans must cover at no cost to you.

How you feel day to day belongs on the list

Numbers aren’t the whole story. Pain that keeps you from walking, sleep that never refreshes or a low mood can shape your life more than a cholesterol reading.

Your own sense of how you’re doing carries real information. In a 2006 review in the Journal of General Internal Medicine, researchers pooled 22 groups of people followed over time¹⁴. People who rated their health “poor” on a single question had about twice the risk of dying during follow-up as those who rated it “excellent”¹⁴. The link held after researchers accounted for other illnesses and depression¹⁴.

The study can’t show that a gloomy rating causes harm. A likely reading is that people notice things about their bodies that tests can miss.

Care built around what patients say matters most is being tested, too. In a Connecticut study led by researcher Mary Tinetti, 366 adults 65 and older with three or more chronic conditions got either usual care or Patient Priorities Care¹⁵. That approach asks people to name their health goals and the care they’re willing to accept, then shapes decisions around them¹⁵.

The priorities group reported a lighter treatment burden. They had medicines stopped more often and fewer tests ordered¹⁵. The clinics weren’t randomly assigned, so the authors call the results suggestive¹⁵.

Natural-health traditions have long asked what a person wants their health for: tending a garden, lifting a grandchild, getting through a workday without pain. That question belongs beside your lab results. Our article on naming your values before a health decision shows one way to sort them.

Some numbers mean a clinician sets the first priority

Knowing the limits of self-care is part of taking charge. Some findings should jump to the top of your list and into a clinician’s hands.

Blood pressure is the clearest case. The 2025 high blood pressure guideline from the American Heart Association and the American College of Cardiology sorts readings this way¹¹:

• Normal: top number below 120 and bottom number below 80.
• Elevated: 120 to 129 on top and below 80 on the bottom.
• Stage 1: 130 to 139 on top, or 80 to 89 on the bottom.
• Stage 2: 140 or higher on top, or 90 or higher on the bottom.

This is the part natural-health readers may welcome. For adults in stage 1 whose PREVENT 10-year risk is under 7.5%, the guideline calls for 3 to 6 months of lifestyle change first¹¹. If pressure stays at 130/80 or higher after that trial, medicine is recommended¹¹. The guideline also strongly recommends cutting sodium, eating more potassium-rich food and drinking less alcohol, or none¹¹.

The plan changes for others. People in stage 1 with a risk of 7.5% or more, or with diabetes, kidney disease or past heart disease or stroke, may start medicine sooner¹¹. Adults in stage 2 are advised to start medicine, preferably two drugs combined in one pill¹¹.

Readings above 180/120 count as severe high blood pressure, which the guideline says needs a clinician’s evaluation and treatment¹¹. If a very high reading comes with symptoms that scare you, our guide to symptoms that mean call 911 explains what to do.

Other signs that a clinician should go first:

• A prediabetes test score of 5 or more, which calls for a blood test⁵.
• One of the four family patterns in the box above⁶.
• A breast cancer risk estimate you want to act on, or any reason the NCI tool doesn’t fit you¹².
• Any symptom that is new, severe or getting worse.

Score your choices on one page

Once you know your numbers, family patterns and daily problems, you’ll probably have more candidates than you can handle. This worksheet, our own planning tool rather than a tested instrument, helps you pick one or two.

1. List up to six candidates. Try to include one from each source: a measured number, a family pattern, a screening you’re due for and a problem you feel.
2. Pull out the red flags first. Anything on the “clinician goes first” list skips the scoring. Book that appointment now.
3. Score the rest from 1 (low) to 3 (high) on impact (how much it could change your health or daily life), readiness (whether your time, money and support allow it this month) and urgency (whether waiting makes it worse).
4. Multiply the three scores. The highest total wins. Break a tie in favor of the one you’re more ready for, because a change you start beats one you keep postponing.
5. Write it down with a review date four to twelve weeks out.

Possible priority	Where it came from	Impact (1-3)	Readiness (1-3)	Urgency (1-3)	Total (multiply)
Example: home blood pressure averaging 134/84	My numbers	3	2	2	12
Example: overdue colon cancer screening	Screening for my age	3	2	2	12
Example: waking at 3 a.m. most nights	How I feel	2	3	1	6
Example: mother has type 2 diabetes	Family history	3	2	2	12
________	__	__	__	__	__
________	__	__	__	__	__

The rows are hypothetical. Picture a 52-year-old with that list: three items tie at 12. One clinic visit could handle all three.

Confirm the blood pressure and run PREVENT, ask whether a blood sugar test makes sense, and book the screening. Sleep becomes the next project.

My first priority: ____. My first step this week: ___. Review date: _.

What the evidence shows

Claim	Evidence rating	What it rests on
Family history signals higher risk for common diseases such as heart disease, diabetes and some cancers	Strong evidence	CDC guidance on patterns such as early onset and several affected relatives6
PREVENT sorts adults 30 to 79 by risk of heart attack, stroke and heart failure	Strong evidence for groups	Built from data on more than 6.5 million U.S. adults; meant for use with a clinician910
A risk calculator can tell you whether you personally will get a disease	Evidence says no, or unsafe	Estimates describe groups; NCI notes that some women with high estimates never get breast cancer12
Less sodium, more potassium and less alcohol help lower blood pressure	Strong evidence	Strongly recommended in the 2025 AHA/ACC guideline, which gives lower-risk stage 1 adults 3 to 6 months of lifestyle change first11
One question rating your own health predicts how long people live	Strong evidence	Review of 22 cohorts; “poor” vs. “excellent” carried about twice the risk of death14
Building care around what patients say matters most eases treatment burden	Promising but early	One nonrandomized study of 366 older adults with several conditions15
A scoring sheet like ours picks the best first change	Not enough evidence	A practical planning aid that hasn’t been tested

Questions readers ask

The bottom line

You don’t have to fix everything. You have to fix the right thing first. Start by learning what’s true about you: your blood pressure, your blood sugar risk, your family’s patterns and the screenings due for your age. Then add what you feel every day and what you want your health for.

Score your options, let a clinician lead when a number is far out of range, and give your top choice a few steady months before you add the next one. That’s prevention at its most practical.

Related reading

• Name your values before a health decision, because a pros-and-cons list isn’t enough
• The preventive care that costs you nothing, and the exceptions
• Why one flagged lab number is not a diagnosis
• What to bring, write down and ask before a doctor visit
• The health record nobody else is keeping for you

Sources

1. CNN Wire (via ABC7 News). “This Risk Assessment Tool Helped Olivia Munn Discover Her Breast Cancer.” March 14, 2024. abc7news.com
2. Fryar CD, Kit B, Carroll MD, Afful J. “Hypertension Prevalence, Awareness, Treatment, and Control Among Adults Age 18 and Older: United States, August 2021–August 2023.” NCHS Data Brief No. 511, October 2024. cdc.gov
3. Centers for Disease Control and Prevention. “National Diabetes Statistics Report.” CDC, updated September 16, 2026. cdc.gov
4. Centers for Disease Control and Prevention. “Do I Have Prediabetes? National Prediabetes Awareness Campaign.” CDC, updated September 11, 2026. cdc.gov
5. Centers for Disease Control and Prevention. “About the Prediabetes Risk Test.” CDC, reviewed April 13, 2021. cdc.gov
6. CDC National Office of Public Health Genomics. “Family History” (fact sheet). CDC Stacks. stacks.cdc.gov
7. National Human Genome Research Institute. “Family Health History for Patients and Families.” NIH, updated January 5, 2023. genome.gov
8. National Cancer Institute and National Human Genome Research Institute. “My Family Health Portrait.” cbiit.github.io
9. American Heart Association News. “What PREVENT Can Tell You About Heart Disease Risk.” August 31, 2026. heart.org
10. American Heart Association. “PREVENT Frequently Asked Questions for Patients.” AHA Professional Heart Daily. professional.heart.org
11. American Heart Association. “Top Things to Know: 2025 High Blood Pressure Guideline.” AHA/ACC guideline published August 14, 2025, in Circulation and Hypertension. professional.heart.org
12. National Cancer Institute. “Breast Cancer Risk Assessment Tool: Online Calculator (The Gail Model).” NCI. bcrisktool.cancer.gov
13. U.S. Preventive Services Task Force. “A and B Recommendations.” USPSTF, accessed October 2026. uspreventiveservicestaskforce.org
14. DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P. “Mortality Prediction With a Single General Self-Rated Health Question: A Meta-Analysis.” Journal of General Internal Medicine, 2006;21:267-275. link.springer.com
15. Tinetti ME, Naik AD, Dindo L, et al. “Association of Patient Priorities-Aligned Decision-Making With Patient Outcomes and Ambulatory Health Care Burden Among Older Adults With Multiple Chronic Conditions: A Nonrandomized Clinical Trial.” JAMA Internal Medicine, 2019. jamanetwork.com