Elizabeth Blackwell, the first licensed female physician in the USA, set a standard in the 19th century: medicine should be preventive, systematic, and accessible. The same principle applies today for heart prevention – only with better tools. For high performers, this means: the right tests, in the right rhythm, with clear consequences. This is how prevention becomes a performance strategy.

Heart health can be planned. Three silent drivers increase the risk of cardiovascular diseases: elevated blood pressure, unfavorable blood lipids, and disturbed glucose metabolism. Blood pressure measures the force with which blood presses against the vessel walls. A consistently elevated value gradually damages vessels and heart muscle. The lipid profile summarizes relevant blood lipids, primarily LDL-cholesterollipoprotein that can transport cholesterol into the vessel wall and HDLtransports excess cholesterol back to the liver. Blood sugar shows how well your body regulates glucose; persistently elevated values promote inflammation and vascular damage. The ECGelectrocardiogram, electrical activity of the heart to detect arrhythmias identifies disturbances that are often not felt. Aha moment: many of these risks are asymptomatic. Waiting for symptoms is too late – those who test gain time and room for action.

Uncontrolled blood pressure significantly increases the risk of heart attack, stroke, and heart failure. Studies show that precise measurement and prompt treatment improve blood pressure control sustainably – and thereby prevent events ^[1]. Home-measured values provide a more realistic picture of daily life and help avoid misdiagnoses; even the correct measurement frequency alters decisions ^[2]. Elevated LDL cholesterol works silently but powerfully: it drives atherosclerosis, often for years without warning signs. Regular lipid profiles allow for early intervention and reduce long-term risk ^[3]. Glucose abnormalities are not just a diabetes problem. Even before a diabetes diagnosis, high blood sugar harms the vessels. Conscious monitoring improves lifestyle behaviors and, thus, cardiometabolic health – a lever for prevention and performance ^[4]. In the case of arrhythmias, timing is crucial. An ECG clarifies whether harmless extra beats are present or whether treatment is required for arrhythmias – important, as rhythm disturbances can cause strokes and performance declines ^[5].

In primary care practices, the MAP concept – measure accurately, act swiftly, involve patients – significantly improved blood pressure control within six months, and the effects lasted for up to twelve months. The practical core: clean measurement, less therapeutic inertia, shared decisions ^[1]. Additionally, a population-based evaluation shows that home blood pressure measurement over at least three days provides a stable assessment. Notably, the first measurement day is typically higher; if it is omitted in short measurement sequences, the average and variation decrease, making the diagnosis more precise. Seven days are ideal, with three days as the minimum ^[2]. In metabolism, a randomized experiment with at-risk individuals revealed an interesting effect: continuous glucose measurement increased health awareness and improved lifestyle behaviors more than standard information – monitoring as a behavioral driver ^[4]. In arrhythmia diagnostics, modern, AI-supported analysis of ECG signals achieves impressive accuracy. For everyday use, this means: ECGs become more sensitive and quicker to interpret, supporting the early detection of relevant arrhythmias – despite open questions about datasets and explainability ^[5].

- Blood Pressure: Have your blood pressure professionally measured at least once a year. Additionally, use home blood pressure measurements for 7 days (minimum 3 days). Tip: Measure in the morning and evening, sit quietly for 5 minutes, and exclude the first day from the evaluation in 3-day protocols ^[2]. If a high practice value is identified, the doctor and patient should discuss treatment options promptly – the MAP principle helps close implementation gaps ^[1].
- Lipid Profile: Schedule a complete lipid profile at least every 5 years. Test more frequently with family predisposition, obesity, or high performance stress and set LDL goals individually. Consider cascade screening within the family if familial hypercholesterolemia is suspected ^[3].
- Blood Sugar: Check fasting glucose or HbA1c if there are risk factors such as obesity or a family history of diabetes. Consider phased continuous glucose monitoring to optimize eating and training patterns – monitoring has been shown to promote healthy behavior ^[4].
- ECG: If experiencing chest pain, palpitations, dizziness, or performance decline, have an ECG performed promptly. Consider outpatient monitoring for recurring symptoms; AI-supported analysis can improve detection but does not replace medical assessment ^[5].

The coming years will bring smarter sensors, AI-supported ECG analyses, and personalized screening schemes together. Research will clarify how continuous glucose and blood pressure data, combined with lipid profiles, can guide individual prevention plans. Those who start precise measurement today will benefit tomorrow from even more targeted, data-driven heart strategies.