🫀 Heart, cholesterol & blood pressure

5 mechanistic pathways · 68 options

This is the goal with the strongest causal evidence base in the entire Vault, and the least excitement attached to it. ApoB particle count and blood pressure are the two variables with the most robust causal relationship to how long you live. Everything else here is refinement. Know your numbers first: ApoB, Lp(a) once in your life, blood pressure at home, and hs-CRP.

Nothing here is ranked by evidence tier. A lot of what works in this space has never had the trial run, and sorting by trial count would bury exactly the compounds you came looking for. The tier is a label. The mechanism is the map.

The pathways

ApoB & LDL particle reduction

12 options

Atherosclerosis is caused by ApoB-containing particles crossing into the arterial wall and being retained. Fewer particles, less retention — and the relationship is causal, dose-dependent and cumulative over a lifetime, which is why starting early matters more than starting aggressively.

Endothelial function & nitric oxide

20 options

The endothelium is a single cell layer regulating tone, clotting and inflammation. Its dysfunction precedes plaque by decades and is measurable long before anything shows on a scan — which makes it the earliest place to intervene.

Thrombosis, Lp(a) & residual risk

13 options

Plaque doesn't kill you — the clot on a ruptured plaque does. And Lp(a) is genetically determined, unaffected by diet and lifestyle, raised in about one in five people, and almost never tested. If you measure one unusual thing in your life, measure this once.

Cardiac energetics & heart failure support

13 options

The heart is the most mitochondria-dense tissue in the body — roughly a third of cardiomyocyte volume — and it never rests. Failing hearts are energy-starved, which is a substrate problem as much as a pump problem.

Venous & microcirculation

10 options

The forgotten half of the circulation. Veins return blood against gravity using valves and vessel-wall tone, and when that fails you get varicosities, heaviness, oedema and haemorrhoids. Different tissue, different mechanism, and genuinely responsive to flavonoids — this is one of the better-evidenced areas in botanical medicine and one of the least discussed.

Test before you choose a pathway

Every route below can be argued for on mechanism. Only bloodwork tells you which one is actually your problem — and picking the wrong pathway is the most common reason someone concludes "none of this works". Across all 5 pathways, these are the 21 markers worth having in front of you first.

The next step

You have the pathways. Here is the stack.

The Cardiovascular Blueprint names the one compound I would start with in each of these 5 pathways, what it was chosen over, and why — plus 25 options to swap in or stack on top, every one of them priced and linked.

Free, no email. The week-by-week schedule is the part that lives in the Academy.

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The protocols behind these

Dosing, stacking and cycle timing live inside the Academy, alongside the full interactive Vault and the Bloodwork Protocols.

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← Open Heart, cholesterol & blood pressure in the interactive Vault · All 21 goals

Frequently asked questions

How many ways are there to approach heart, cholesterol & blood pressure?

This goal is broken into 5 distinct mechanistic pathways — ApoB & LDL particle reduction; Endothelial function & nitric oxide; Thrombosis, Lp(a) & residual risk; Cardiac energetics & heart failure support and others — across 68 compounds and supplements. Each pathway is a different argument about how the body gets there, so the useful question is which one matches where you are actually stuck.

Which pathway should I start with for heart, cholesterol & blood pressure?

The one that matches your actual limitation, which bloodwork usually settles faster than guessing. An appetite drug does nothing for someone who already undereats, and a thyroid intervention does nothing if your thyroid is fine. Each pathway page lists the markers that tell you whether it is your problem.

Are the 5 heart, cholesterol & blood pressure pathways ranked best to worst?

No. The 5 pathways are listed in mechanistic order, not by strength of evidence, and neither are the 68 options inside them. A lot of what works in this space has never had the trial run, and sorting by trial count would bury exactly the compounds you came looking for.

Educational and research reference only — not medical advice, and not a recommendation for human use. Mechanistic predictions are exactly that: what the biology suggests should happen, which is not the same as what has been shown to happen.