Focus: Longevity, early risk detection, cardiometabolic health
Context: Indian adults, asymptomatic, prevention first


1. Cardiovascular Health

Test Frequency Optimal / Action Threshold Purpose
Blood Pressure Every visit / annually Optimal <120/80 mmHg, act if ≥130/80 Checks pressure inside arteries; high values silently damage heart, brain, kidneys
Lipid Profile (TC, LDL-C, HDL-C, TG) Annually LDL-C <100 mg/dL, TG <150 mg/dL Measures blood fats that contribute to artery blockage
Apolipoprotein B (ApoB) Annually Optimal <80 mg/dL, high risk ≥100 Counts harmful cholesterol particles that enter artery walls
Lipoprotein(a) Once in lifetime (repeat post-menopause in women) Elevated ≥30 mg/dL Detects inherited risk for early heart disease
hs-CRP Annually Low risk <1.0 mg/L, high ≥3.0 Detects hidden inflammation damaging blood vessels
ECG Annually Any new abnormality Screens heart rhythm and electrical activity
Echocardiogram Every 2–3 years Structural or EF abnormality Ultrasound to check heart size, pumping strength, and valves
CAC Score Every 3–5 years 0 ideal, >100 high risk Measures actual calcium plaque in heart arteries
Stress Echo (Also called TMT) Every 2–3 years (selective) Abnormal wall motion Checks blood flow to heart during exercise or stress

Derived metric:

  • Triglyceride/HDL ratio (from lipid profile)
    Optimal <2.0; insulin resistance likely if >3.0

2. Metabolic Health and Insulin Sensitivity

Test Frequency Optimal / Action Threshold Purpose
Fasting Glucose Annually Optimal <100 mg/dL Measures current blood sugar level
HbA1c Annually Optimal <5.7% Shows average blood sugar over 3 months
Fasting Insulin Annually Optimal <5–10 μU/mL Detects early insulin resistance before diabetes

Calculated index:

  • HOMA-IR = fasting glucose × insulin / 405
    Optimal <1.5–2.0
    Purpose: quantifies how hard insulin is working to control sugar

3. Inflammation, Micronutrients, Aging Markers

Test Frequency Optimal / Action Threshold Purpose
Serum Ferritin Annually 40–100 ng/mL Measures iron stores; low levels cause fatigue even with normal hemoglobin
Homocysteine Annually <10–12 μmol/L Signals vitamin B12/folate deficiency and vascular aging
Vitamin D (25-OH) Annually 40–80 ng/mL Assesses vitamin D status for bones, immunity, muscles
Serum Calcium (total) Annually Lab reference range Safety check during vitamin D supplementation
Vitamin B12 Annually >500 pg/mL Supports nerve function, energy, cognition

Notes:

  • Calcium is a safety marker, not a vitamin D absorption test
  • Add PTH only if vitamin D is low or calcium abnormal

4. Liver, Kidney, Thyroid

Test Frequency Optimal / Action Threshold Purpose
Kidney Function Test (KFT) Annually eGFR >90 Checks kidney filtration and waste removal
Liver Function Test (LFT) Annually ALT/AST <25–30 U/L Detects fatty liver, alcohol or medication stress
TSH Annually Ideal ~0.5–2.5 mIU/L Screens thyroid hormone balance affecting energy and weight

Add T3 and T4 only if TSH abnormal or symptoms present


5. Female-Specific Additions

Test Frequency Action Threshold Purpose
Mammogram Every 1–2 years after 40 BI-RADS ≥3 Early detection of breast cancer
Pap Smear Every 3 years Any abnormal result Detects cervical cancer early
HPV DNA Test Every 5 years Positive Identifies cancer-causing HPV infection
Bone Density (DEXA) Once post-menopause, repeat per risk T-score ≤-2.5 Measures bone strength and fracture risk
Ferritin focus Annual <40 ng/mL Iron deficiency common in women
Thyroid vigilance Annual Abnormal TSH Higher thyroid disorder risk in women

6. Male-Specific Additions

Test Frequency Action Threshold Purpose
PSA Annually after 45 0–3.5 ng/mL Screens prostate health and cancer risk

Interpretation Guide (High-Level)

Cardiovascular

  • High ApoB with normal LDL = too many harmful particles
  • CAC >0 indicates existing artery disease
  • High Lp(a) requires stricter cholesterol control

Metabolic

  • Normal sugar but high insulin = early metabolic trouble
  • Rising HbA1c predicts future diabetes

Inflammation

  • hs-CRP >2 mg/L suggests vascular inflammation
  • High homocysteine accelerates aging and brain decline

Nutrients

  • Vitamin D <30 ng/mL needs correction
  • High calcium with supplements suggests overdose risk
  • B12 <400 pg/mL can cause nerve damage

Liver and Kidney

  • Mildly high ALT often signals fatty liver
  • Falling eGFR trend matters more than a single value

Key Principles

  • Separate measured tests from calculated indices
  • Avoid unnecessary annual imaging
  • Track trends over time
  • Act early before disease appears