I feel fine. My numbers look okay. Why should I be doing all this extra testing?

Because fifty percent of men who die of coronary artery disease have no prior symptoms. The first symptom they experience is the one that kills them. The cardiac system in a man whose LAD is 60% stenosed can deliver entirely adequate oxygen during rest and moderate activity. He feels fine. He is not fine. He is eight months away from the cardiac event that will either kill him or be the beginning of a much more constrained life. Feeling fine is the cardiovascular system's gift to itself while there is still time. The absence of symptoms is not the absence of disease. It is the definition of subclinical disease.

The specific reason for extra testing in a Black man with "okay" numbers is the systematic gap between "numbers within reference range" and "numbers ideal for your specific biology." A LDL of 112 mg/dL is "normal." An ApoB of 158 mg/dL on the same man is not best, and the annual physical only ordered the LDL. A blood pressure of 136/86 is "borderline." A blood pressure of 136/86 sustained for five years in a Black man who has never had his LV mass measured is hypertensive cardiomyopathy in progress. The numbers that look okay are often looking at the wrong things. Feeling fine and having okay numbers is the starting point for the assessment, not the conclusion of it. (American Heart Association, Heart Disease and Stroke Statistics 2024)

Cardiologist's calibrated position, Solid (1) for the gap between symptom absence and cardiovascular risk absence.

What to do: Schedule the six-test panel described in Q24.14. The tests are not looking for disease you feel. They are looking for disease that will not feel like anything until it is not subclinical anymore.

For the full picture, read The Cardiac Inheritance.

## Category 25: The Mogire Cardiac Risk Audit (Product FAQ)
Deep Dive: The Mogire Cardiac Risk Audit