What are the most common findings in Mogire Cardiac Risk Audits?

In men who present with "clean" annual physicals, the most frequent findings are: (1) LDL-ApoB discordance, LDL appearing acceptable while ApoB is meaningfully elevated, particularly in men with elevated triglycerides and insulin resistance; (2) Lp(a) elevation, never previously measured, discovered to be above 70 nmol/L in approximately 20–25% of men audited, changing risk stratification and ApoB target aggressiveness; (3) masked hypertension, office blood pressure appearing borderline or normal while home blood pressure average exceeds 130/80, confirmed via home monitoring for the first time; (4) insulin resistance, fasting insulin above 10 mIU/mL in a man with "normal" HbA1c, identifying the upstream driver of metabolic cardiovascular risk years before glucose becomes abnormal; (5) hs-CRP above 2.0 mg/L with no identified driver, requiring systematic assessment of visceral fat, sleep apnea, dental health, and insulin resistance as the four most common reversible contributors.

These are not rare findings. They are common patterns in men who have been receiving annual physicals that examined some of the right variables and missed others.

What to do: The most frequent response to these findings in an Audit is: relief. Not alarm. Relief that the measurement exists, that the finding has a name, and that the name has a treatment or management strategy. The finding is not the end of the story. It is the beginning of the chapter where something changes.

For the full picture, read The Mogire Cardiac Risk Audit.