Question 65 of 433
What thirteen areas belong in a prevention review?
The short answer
I use thirteen areas to organize a prevention conversation. They are not thirteen targets that everyone must measure or drive downward.
1. Blood pressure: often below 130/80 mm Hg when treatment is indicated, with attention to dizziness, frailty, and measurement technique.
2. LDL cholesterol and, selectively, ApoB: targets depend on established disease and overall risk.
3. Lp(a): generally once in adulthood, to identify inherited cardiovascular risk.
4. Glucose regulation: HbA1c, fasting glucose, or a glucose tolerance test as appropriate. A lower result is not always better, especially during glucose-lowering treatment.
5. Triglycerides and HDL: useful context within the full lipid profile. Their ratio is not a standardized diagnostic test for insulin resistance.
6. Waist size: interpreted with body build and ethnic background, alongside other risks.
7. Kidney function: eGFR and urine albumin when indicated, particularly in diabetes or kidney disease.
8. Liver health: routine tests and fibrosis assessment when metabolic or other risks justify them.
9. Fitness: a walk test, an exercise history, or a more formal assessment suited to your ability.
10. Strength and balance: measured safely, with attention to changes over time.
11. Bone and fracture risk: history first; bone-density testing at the appropriate age or risk level.
12. Screening and vaccination status: the interventions appropriate to your age, health, and preferences.
13. Medication and supplement review: benefits, adverse effects, interactions, cost, and what can be simplified.
Fasting insulin and hs-CRP are not compulsory additions. I may consider selected markers when a specific unresolved question makes them useful. Routine insulin testing is not recommended by the ADA/AACC guideline, and there is no universal insulin or HOMA-IR treatment target.
“This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship.” From the book’s medical disclaimer. Full disclaimer
CLINICAL FRAMEWORK — Adult prevention topics; selective testing, not thirteen universal numeric targets.Evidence grade (draft mapping)JClinical judgment / author synthesisPart 5, Q65 · Sources: R1, R4
Sources cited
- R1 Sacks DB et al. Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus. Diabetes Care. 2023;46:e151–e199. doi:10.2337/dci23-0036. PubMed 37471273DOI 10.2337/dci23-0036✓ Verified
- R4 Blumenthal RS et al. 2026 ACC/AHA multisociety Guideline on the Management of Dyslipidemia. Journal of the American College of Cardiology. 2026. doi:10.1016/j.jacc.2025.11.016. Link pending verification
From Longevity Unmasked by Afshine Ash Emrani, MD, FACC. Medical disclaimer. This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship. Nothing here is meant to diagnose, treat, cure, or prevent any disease. Medicine is personal: a test, drug, supplement, or exercise plan that helps one person can harm another. Do not start, stop, or change any medication or treatment because of something you read in these pages. Talk with a licensed clinician who knows your history first. If you think you are having a medical emergency, call 911. The author disclaims responsibility for any loss or harm arising from use of the information in this book.