Cardiovascular risk
The Cardiovascular Stack
The stack that actually extends life — the one the physique sites barely mention.
For: Every adult who wants to not have the heart attack. Especially with family history.
Heart disease is the thing most likely to end your life early, and it's unusually manageable. Know your ApoB and blood pressure, move the numbers with lifestyle, and — when risk is high — with medication that has decades of trial evidence. This is where StackGuide diverges hardest from the compound catalogs: the highest-impact 'stack' for longevity is mostly boring cardiology.
If longevity is the goal, this is quietly the most important stack in the guide — and it’s the one the compound catalogs skip, because there’s nothing exotic to sell. Cardiovascular disease is the leading cause of early death, and it is also one of the most measurable and manageable things about your body. Two numbers do most of the work: ApoB (or LDL-C), which is causally and cumulatively tied to heart disease, and blood pressure, the silent multiplier behind heart attack and stroke.
The base is lifestyle: the Mediterranean-style pattern with the best trial record, an aerobic base that independently predicts survival, and less alcohol. When calculated risk stays high despite all that — often because of genetics, not discipline — the medications here are not a failure but a tool, and an unusually well-evidenced one. Statins are the workhorse; ezetimibe and PCSK9 inhibitors extend the reach; aspirin is a secondary-prevention tool that’s mostly wrong for primary prevention. None of this is glamorous. All of it is a clinician conversation. And together it does more for how long you live than every peptide in the frontier section combined.
The protocol
The backbone
Does the work. Build these first.- ApoB / LDL Heart & Metabolic A
Measure ApoB (or LDL-C). It's causal and cumulative — lower and earlier is better.
- Blood pressure Heart & Metabolic A
Know it from several proper readings; target roughly <130/80 with a clinician.
- Nutrition Foundations B
A Mediterranean-style pattern has the best cardiovascular trial evidence of any diet.
- Aerobic base Foundations A
Cardiorespiratory fitness is a powerful, independent predictor of survival.
- Alcohol Foundations B
No amount improves cardiovascular health; less is better.
Subtraction.
Situational
Low-stakes; useful only in the right case.Understand, don't just add
Powerful or hyped — a clinician conversation, not a casual add.- Statins Medications A
The workhorse. Lowers LDL and events with strong evidence; a clinician decides by your absolute risk.
- Ezetimibe Medications A
Adds to a statin when LDL isn't low enough, or when statins aren't tolerated.
- PCSK9 inhibitors Medications A
Injectables that drive LDL very low for high-risk patients; cost and access are the limits.
- Low-dose aspirin Medications A
Valuable after an event; usually not worth the bleeding risk for primary prevention.
Build it in this order
- 1 Measure ApoB and blood pressure — you can't manage what you haven't seen.
- 2 Move both with the food pattern, fitness, and less alcohol.
- 3 If calculated risk stays high, take the medication conversation seriously — the trial evidence is on its side.
What to skip
- Ignoring cholesterol and blood pressure because they're silent — that silence is the danger.
- Reaching for fish oil as cardioprotection for an average person; the good trials are null.
- Starting or stopping aspirin on your own.