What is Dr. Mogire's philosophy about pharmaceutical interventions in prevention?

The pharmaceutical philosophy is evidence-grounded, non-dogmatic, and individualized. Statins, antihypertensives, semaglutide, low-dose colchicine, PCSK9 inhibitors, each of these drugs has trial evidence quantifying its benefit in specific populations. The question is never "are you for or against medication?" It is: does the evidence justify this drug for this man's specific risk profile?

Where Dr. Mogire departs from both the lifestyle-only and the medication-first camps: lifestyle interventions are not "tried first and then replaced by drugs." They are implemented simultaneously with whatever pharmacological support the evidence justifies. A man with an ApoB of 160 mg/dL who "wants to try diet first" for six months before discussing statin therapy is reasonable if his risk is truly low-intermediate. A man with an ApoB of 160 mg/dL, Lp(a) of 85 nmol/L, CAC of 95, and a family history of MI at 54 who "wants to try diet first" is delaying a pharmacological intervention whose benefit at this specific risk level is strongly evidence-graded. The clinical calculation is always risk-specific. The philosophy is: the evidence tells you what to do, not your ideology about medication.

What to do: If you are uncertain about whether a specific medication is appropriate for your risk profile, that uncertainty is exactly what the Mogire Cardiac Risk Audit or Clinical Consultation is designed to resolve.