Attia Cardiometabolic Core (Med 3.0)
Risk: LowPeter Attia's ApoB-driven cardiometabolic stack — rosuvastatin lowers LDL particle count, ezetimibe blocks cholesterol absorption (synergistic with statin), telmisartan controls blood pressure with PPARγ benefits, and empagliflozin lowers cardiovascular events independent of diabetes. The most evidence-backed cardiovascular longevity protocol.
Composition: 3 Ancillaries / PCT · 1 Longevity
Overview
The Attia Cardiometabolic Core stack is the most evidence-driven axis for reducing cardiovascular risk, managing LDL/ApoB, and extending healthspan—without the risk profile of polypharmacy or gray-market compounds. It's designed for serious longevity-focused users, aesthetics and body-recomp enthusiasts stacking performance enhancers who want actual plaque prevention, and anyone serious about walking around with pristine arteries regardless of PED history. This isn't a generic 'wellness' supplement set. Each compound has hard outcome data and solves a distinct piece of the cardiometabolic puzzle: rosuvastatin for ApoB and inflammation, ezetimibe for extra LDL lowering with statin synergy, telmisartan for BP with fat/insulin perks, and empagliflozin for vascular/renal protection and built-in calorie leakage.
Why this stack works
Every slot in this protocol is here for a reason:
- Rosuvastatin is unmatched for rapidly, reliably lowering LDL and ApoB—the single biggest lever on atherosclerosis, whether or not AAS are used. As a hydrophilic statin, it avoids most muscle toxicity concerns and does not interact with common PED ancillaries.
- Ezetimibe stacks cleanly with statins to block gut cholesterol uptake. This double-hit approach drops LDL/ApoB lower than maxing out either agent solo, with minimal side effects or labs to watch.
- Telmisartan covers the blood pressure axis, which is vital when injectables, orals, or GH are used, or just want to slow vascular aging. Its PPAR-γ partial agonism is a free bonus: improved insulin sensitivity, less visceral fat, and softer progression to metabolic syndrome over the years.
- Empagliflozin brings hard outcome data for CV and all-cause mortality (EMPA-REG trial), with built-in calorie loss, improved glycemic control, and diuretic benefits. It's in a different class than metformin or generic diuretics, and can be safely run by non-diabetics at 10 mg/day. Together, these four cover the lipid, BP, and insulin axis at the highest standard of care, with minimal overlap and maximal synergy.
Protocol timeline
1 phase · 52 weeks total
Timeline shows the 52-week cycle. Bars overlap when phases run concurrently. Click a bar to jump to its detail card.
Cycle starts
2025
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2026
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2027
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
| Week | Compound | Dose | Frequency | Notes |
|---|---|---|---|---|
| 1–52 | Rosuvastatin | 5–10 mg | Once daily (AM) | Standard starting dose. May be taken with or without food. |
| 1–52 | Ezetimibe | 10 mg | Once daily (AM) | Usually administered at the same time as rosuvastatin. |
| 1–52 | Telmisartan | 40 mg | Once daily (AM) | Dose can adjust to 80 mg for persistent BP >120/80. |
| 1–52 | Empagliflozin | 10 mg | Once daily (AM) | Morning preferred; may be dosed with or without food. |
- If empagliflozin is used: Avoid prolonged fasting, planned ketogenic/very low-carb diets, contest preps, or surgery/illness without pausing drug (risk of euglycemic DKA increases in these states).
- For telmisartan: If current BP <110/70, titrate lower or split to 20 mg; if persistent hypertension, discuss stacking with low-dose nebivolol (beta blocker) or a DHP calcium channel blocker for extra BP control.
- If running rosuvastatin + ezetimibe (which are being used): Do not stack with red yeast rice, niacin, or other lipid-lowering nutraceuticals unless targeting an LDL/ApoB <40 goal and tolerating the stack well.
- Labs: Baseline and 6–8 week repeat of lipid panel (with ApoB), LFTs, creatinine/eGFR, and fasting glucose/A1C. Telmisartan is liver-cleared, but statins and ezetimibe both need monitoring for rare but real LFT shifts.
Compounds in this stack
4 linked · tap for full guide
Empagliflozin
SGLT2 Inhibitor
Ezetimibe
NPC1L1 Inhibitor / Lipid Ancillary
Rosuvastatin
HMG-CoA Reductase Inhibitor (Statin)
Telmisartan
Angiotensin II Receptor Blocker (ARB) / PPAR-γ Partial Agonist
How they work together
Multipliers applied to the projection above when these compounds run together. Values > 1 indicate a bonus, < 1 a penalty.
| Pair | Type | Lean | Fat loss | Recovery |
|---|---|---|---|---|
| synergistic | ×1.07 | ×1.18 | ×1.12 | |
| synergistic | ×1.00 | ×1.00 | ×1.00 |
Cycle outcome projection
Projection across all phases (52 weeks total) using the same math as the stack-calculator tool. Adjust gender, cycle length, and goal to see how the numbers move.
Body Transformation Preview
Lean Mass Gain
0.0 lbs
0.0–0.0 lbs range
Fat Loss
7.7 lbs
5.8–9.6 lbs range
Lean Synergy Bonus
+7%
from compound pairing
Fat Loss Synergy
+18%
from compound pairing
Per-Compound Contribution
Fat Loss by Week
Where to buy
NextChems
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Conclusion
This is the gold-standard routine for anyone serious about major, durable reductions in cardiovascular risk on or off performance enhancers. Get these set and, more than almost anything, your arteries stay clear for the decades ahead. For those ready to proceed, begin here—and obtain labs in 6–8 weeks.
Updated 2026-04-19