Metabolic health is the foundation of long life and protection from heart attack & stroke. Diabetes, hypertension, abnormal lipids and obesity are shared risk factors for both brain and heart diseases. But are we measuring them the right way? Not always. 1. Blood Pressure A single BP reading in the clinic can mislead. Anxiety and inadequate rest matter. 👉 Home BP monitoring is essential, especially if clinic readings are high. 2. Glucose Metabolism Waiting for diabetes to appear may be too late. 👉 Insulin resistance is the earliest warning sign and can be detected using fasting insulin and HOMA-IR; when lifestyle changes are most effective. 3. Cholesterol LDL cholesterol alone doesn’t tell the full story. 👉 ApoB better reflects all atherogenic particles and cardiovascular risk. 4. Obesity Weight and BMI are crude markers. 👉 Abdominal and visceral fat matter more. Waist circumference and waist-hip ratio outperform BMI. (DEXA/MRI offer precision, when needed.) 5. Sleep Often ignored, yet crucial. 👉 7–9 hours of regular, good-quality sleep lowers cardiovascular risk. 6. Physical Activity Sitting too much is a risk factor by itself. 👉 Both aerobic exercise and strength training should be assessed; not assumed. Bottom line: Early detection + better markers + lifestyle correction result in fewer strokes, fewer heart attacks, and longer life. Dr Sudhir Kumar Neurologist, Hyderabad