Heart Health

The manual starts with the numbers: blood pressure, LDL cholesterol, and glucose — three measurements any clinic can take, and the gauges on the engine. High blood pressure is the single largest modifiable risk factor; LDL management has proven clinical tools whose evidence dwarfs everything on the supplement shelf; and the metabolic markers feed the same vessel disease (the Metabolic Health page is the story underneath).

Then the pillars: not smoking is the single highest-value decision; aerobic fitness is increasingly treated as a vital sign of its own (fitness predicts survival on its own curve); and Mediterranean-pattern eating carries randomized-trial evidence — the landmark PREDIMED trial showed real reductions in major cardiovascular events from a food pattern, not a pill. Blood pressure control, lipids, movement, food pattern, no smoke — five levers, all proven, none purchasable in a bottle.

The supplement story deserves its honest nuance: fish oil — the category's most famous claim — split sharply in the trials. Triglyceride effects are strong and consistent; primary prevention in healthy adults came back null in the huge VITAL and ASCEND trials; and the positive REDUCE-IT result used prescription purified EPA at clinical doses in high-risk patients — not the softgel in your cupboard. The chapters linked below carry each nuance in full.

• Know your three numbers — the gauges on the engine.
• Blood pressure control is the highest-leverage cardiac move there is.
• Aerobic fitness functions as a vital sign — the engine improves with use.
• PREDIMED proved a food pattern (not a pill) reduces events.
• Fish oil: strong for triglycerides, null for prevention in healthy adults.