Building Your Annual Plan
Turning this guide into a repeatable testing and prevention routine
Here's how to turn this guide into a routine you can actually run once a year.
Your Annual Checklist
| Category | What to do | Frequency |
|---|---|---|
| Blood pressure | Measure at a check-up, or at home with a validated cuff | At least annually; more often if elevated |
| Lipid panel + ApoB | Request ApoB specifically alongside standard LDL/HDL/triglycerides | Annually, or as directed if abnormal |
| Fasting glucose + HbA1c | Standard on most annual panels — confirm both are included | Annually |
| Fasting insulin | Request specifically — rarely included by default | Annually, or once to establish a baseline if consistently normal |
| hs-CRP | Request specifically — not on standard panels | Annually, or once as a baseline |
| Lp(a) | Request once | Once in a lifetime — it's genetic and doesn't meaningfully change |
| Waist circumference | Measure yourself with a tape measure | Monthly, as a free trend indicator |
When Numbers Are Off: The General Approach
For most of the modifiable numbers in this guide — blood pressure, triglycerides, HbA1c, fasting insulin, waist circumference — the same core levers move nearly all of them simultaneously: regular aerobic exercise, a Mediterranean- or DASH-style dietary pattern, adequate sleep, reduced alcohol, and not smoking. This is not a coincidence; these numbers share overlapping underlying biology (insulin resistance, visceral fat, inflammation, arterial stress), which is why addressing the fundamentals tends to move several numbers at once rather than requiring a different intervention for each one.
One abnormal number — retest it, apply the relevant lifestyle lever from this guide, and recheck in a few months before assuming it needs medication.
Several abnormal numbers clustering together — particularly triglycerides, waist circumference, blood pressure, and glucose — is the pattern worth flagging explicitly to a doctor as possible metabolic syndrome, since it changes how aggressively the whole picture should be managed.
A strong family history of early heart disease, especially alongside high LDL, is worth raising Lp(a) and familial hypercholesterolemia specifically, rather than assuming standard lifestyle advice fully covers your risk.