NEW 2026 AMERICAN HEART ASSOCIATION GUIDANCE
Heart health nowstarts at 30.
For decades, cardiovascular risk assessment focused largely on middle age. New guidance from the ACC, American Heart Association and nine other medical organizations now recommends estimating both 10- and 30-year risk beginning at age 30.
The reason is simple: cardiovascular disease develops over decades, long before most people feel anything.
NOVOS Science Editorial · 13 min read
What changed
Why medicine is moving cardiovascular prevention earlier
For years, much of routine cardiovascular prevention revolved around estimating a person's chance of having a heart attack or stroke over the next 10 years.
That creates an obvious problem for a healthy 32-year-old.
Their 10-year risk is almost always low because they're young, even when their lifetime trajectory isn't.
Atherosclerosis doesn't suddenly begin when someone turns 50.
Exposure to blood pressure, atherogenic particles, metabolic dysfunction, smoking, and other cardiovascular stressors accumulates over years and decades.
That is the thinking behind one of the most consequential changes in the 2026 ACC/AHA Guideline on the Management of Dyslipidemia. The new guideline recommends using the American Heart Association's PREVENT-ASCVD equations in adults ages 30–79, allowing clinicians to evaluate both near-term and lifetime trajectory.[1]
10-year risk
What's likely in the relatively near future?
30-year risk
Where could the current trajectory lead over decades?
The guideline also places substantially more emphasis on lifetime exposure to atherogenic lipoproteins (cholesterols) and earlier intervention when risk warrants it.[1]
“Treat dyslipidemia earlier to reduce lifelong risk of prolonged exposure to atherogenic lipoproteins.”
2026 Dyslipidemia Guideline
Published March 13, 2026
This does not mean every 30-year-old needs medication or advanced imaging. It means risk assessment and prevention should no longer wait until middle age.
PREVENT · ages 30–79
- 20
- 30
- 40
- 50
- 60
- 70
Formal 10- and 30-year cardiovascular risk estimation used to begin around midlife. It now begins at 30.[1]
Broader than cholesterol
The shift is broader than cholesterol.
The March 2026 guideline was developed by the American College of Cardiology, the American Heart Association, and nine additional professional organizations.[1]
Represented specialties
- Cardiovascular rehabilitation
- Preventive cardiology
- Diabetes
- Geriatrics
- Pharmacy
- Lipid medicine
- Preventive medicine
- Cardiovascular nursing
Three months later, the AHA and ACC joined the American Diabetes Association and American Society of Nephrology to publish the first clinical guideline for cardiovascular-kidney-metabolic syndrome.[2]
Its central idea is equally important: we have historically treated the heart, kidneys, and metabolism as separate systems. Biologically, they aren't.
“Your heart, brain, kidneys and metabolic health are one system.”
One connected system
Heart + Vasculature
- BrainCognition + stroke risk
- KidneysFiltration depends on flow
- Metabolic systemGlucose + lipid handling
- MusclesOxygen + substrate delivery
- Peripheral circulationEvery tissue needs delivery
Blood vessels deliver oxygen, nutrients, hormones and metabolic substrates throughout the body. Vascular health is whole-body health.
The scale of the problem
The world's #1 killer isn't cancer.
It's cardiovascular disease.
Heart disease has remained America's leading cause of death for both men and women for more than a century. And globally, cardiovascular disease remains the largest cause of death by a wide margin.[5]
United States · 2024 final CDC data
- Heart disease683,491deaths
- Cancer619,876deaths
- Stroke166,852deaths
- Alzheimer's disease116,022deaths
Heart disease alone killed more Americans than cancer in 2024.
Heart disease + stroke accounted for more than 850,000 U.S. deaths.
These categories are shown separately as recorded by CDC. Cardiovascular disease is a broader category encompassing multiple heart and vascular disorders. Source: CDC National Center for Health Statistics, final 2024 mortality data.[4]
United States · prevalence
Worldwide
≈20 million
cardiovascular deaths in 2022 — approximately 32% of all global deaths.
World Health Organization.[5]
≈10 million
cancer deaths in the latest WHO estimate. Dementia is the 7th leading cause of death globally, with approximately 57 million people living with dementia in 2021.
These estimates come from different reporting years and should not be interpreted as direct same-year comparisons.[5]
One distribution network
Your arteries don't serve one organ.
They serve all of them.
The cardiovascular system is a distribution network.
Every minute, the heart pushes blood through vessels that deliver oxygen and nutrients throughout the body. That includes the organs people tend to associate with “heart health.” But it also includes organs they often don't.
Where circulation matters
Brain
Blood flow + cognition
Kidneys
Filtration depends on blood flow
Muscle
Oxygen delivery
Peripheral tissues
Every tissue needs delivery
Heart
The pump needs its own blood supply
The good news
Heart disease usually gives you decades to intervene.
The same fact that makes cardiovascular disease dangerous also creates its biggest opportunity. It usually develops over time.
- Atherosclerotic exposure accumulates.
- Blood pressure trends upward.
- Arteries gradually stiffen.
- Endothelial function declines.
- Metabolic health changes.
That means the years before disease becomes clinically obvious are not empty years. They're the window in which prevention has the greatest leverage. If you're over 30, that means now is the time to work on prevention.
“As much as 80% of heart disease and stroke is preventable with lifestyle changes.”
Individual risk varies
Individual risk varies, and genetic conditions or established disease may require medical treatment in addition to lifestyle.[3]
What to do now
Start with what has the strongest evidence.
Lifestyle and appropriate medical care come first. Everything after that is an addition, not a replacement.
150 minutes is the minimum. 150–300 is the evidence-based target range.
Current U.S. physical-activity guidance recommends adults accumulate:
- 150–300 minutes/week of moderate-intensity aerobic activity
- or 75–150 minutes/week of vigorous activity
- or an equivalent combination
- plus muscle-strengthening exercise at least 2 days/week
More activity can provide additional health benefits. Moderate examples include brisk walking, easy cycling and moderate hiking; vigorous examples include running, hard cycling, swimming and vigorous interval training.[7]
Mediterranean-style works because the whole pattern works.
The American Heart Association explicitly endorses Mediterranean-style eating as one heart-healthy dietary pattern.[6]
More
- Vegetables
- Fruit
- Legumes
- Whole grains
- Nuts and seeds
- Fish
- Minimally processed food
- Unsaturated fats such as olive oil
Less
- Saturated fat
- Sodium
- Added sugar
- Refined carbohydrates
- Heavily processed foods
- Processed and fatty meats
If you don't drink alcohol, don't start for cardiovascular health.
7–9 hours
Healthy sleep is one of the American Heart Association's Life's Essential 8. Sleep influences blood pressure, glucose regulation, appetite, brain function, and cardiovascular recovery.[8]
Avoid inhaled nicotine entirely.
Avoid tobacco and inhaled nicotine exposure. This remains one of the most powerful modifiable cardiovascular risk factors.[8]
Without pretending stress is one hormone.
Chronic stress can influence sleep, blood pressure, physical activity, eating behavior, and medication adherence.
Useful strategies may include regular exercise, adequate sleep, social connection, relaxation techniques, mindfulness, and reducing avoidable sources of persistent stress.
Stress management is important, but the evidence linking particular stress-reduction interventions to cardiovascular-event reduction is not as strong as the evidence for smoking cessation, blood-pressure control, exercise, and lipid management.
Know your numbers
The new guidance makes this important earlier.
Speak with your doctor to get these tests run for you, starting at 30 years old, and track them over time.
- Blood pressure
- LDL-C / non-HDL-C
- ApoB where appropriate
- Lp(a) at least once in adulthood
- Blood glucose / HbA1c
- Kidney function
- Weight / waist measures
Plus PREVENT 10-year and 30-year risk beginning at age 30. The updated guideline recommends Lp(a) measurement at least once in adulthood and selective use of ApoB to refine risk.[1]
Selective CAC
Men 40+ · Women 45+, when borderline or intermediate risk remains uncertain and imaging could change the treatment decision. A coronary calcium scan is not recommended for every 30-year-old.[1]
Medication
Lifestyle first does not mean lifestyle only.
For some people, lifestyle optimization may be sufficient.
For others, particularly those with substantially elevated LDL-C, diabetes, chronic kidney disease, familial hypercholesterolemia, high lifetime risk, or other significant risk factors, clinicians may recommend prescription therapy.
Examples may include lipid-lowering or blood-pressure medications and, in appropriate cardiovascular-kidney-metabolic conditions, other evidence-based therapies. The decision belongs with a qualified healthcare professional.[1]
How vascular health is measured
Risk markers tell one part of the story.
Functional markers tell another.
Not every cardiovascular measurement tells you the same thing. Some describe cumulative exposure. One describes structure. Others describe how the system is behaving right now.[13]
Exposure + risk markers
- LDL-C
- How much cholesterol is being carried in LDL particles.
- ApoB
- Approximately reflects the number of atherogenic lipoprotein particles.
- Lp(a)
- A largely genetically determined atherogenic particle associated with higher lifetime risk.
These help characterize exposure and future risk.
Structural measure
- CAC
- Has calcified coronary plaque accumulated? A coronary calcium scan provides evidence of established calcified coronary atherosclerosis.
This describes what has already accumulated.
Functional / physiological
- FMD
- Can the blood vessel dilate appropriately?
- PWV
- How stiff or flexible are the large arteries?
- SBP
- How much pressure does the arterial system experience when the heart contracts?
These tell us how the cardiovascular system is functioning.
ApoB and LDL represent an important causal atherogenic pathway; they are not unimportant simply because they are blood biomarkers. Risk biomarkers and functional biomarkers are complementary — not competing.
A harder category
Which raises an interesting question.
Lifestyle intervention has extensive evidence.
Medication has extensive evidence when medically indicated.
But nutritional supplements are a more difficult category.
Many cite mechanistic studies.
Others cite trials of one ingredient contained somewhere inside a much larger formulation.
Far fewer test the finished product people actually consume against placebo, and look at functional biomarkers.
NOVOS Core did.
Randomized human research
What happened when NOVOS Core was tested on vascular function?
Researchers at the University of Surrey conducted a randomized, double-blind, placebo-controlled trial of NOVOS Core in generally healthy adults aged 40 and older without established cardiovascular disease.[9]
Study design
- Design
- Randomized, double-blind, placebo-controlled
- Site
- University of Surrey, United Kingdom (single centre)
- Duration
- 6 months of daily supplementation
- Population
- Generally healthy adults 40+ without established cardiovascular disease
- Primary endpoint
- Flow-mediated dilation (FMD)
- Secondary endpoints
- Pulse wave velocity, blood pressure, lipids
- Registration
- ClinicalTrials.gov NCT06145087
- Publication status
- SSRN preprint · Manuscript currently under peer review
61
randomized and researchers double blinded
males & females
balanced study design
6 months
daily supplementation or placebo
- Randomized
- Double blind
- Placebo controlled
- University-run
- Pre-registered
- Finished formulation
Study transparency
- Who funded it?
- NOVOS provided the intervention and placebo and an unrestricted research grant to the University of Surrey.
- Who controlled the study?
- The university researchers conducted the trial. Senior author Professor Christian Heiss, a cardiologist, Associate Head of School, and author of more than 200 cardiology papers, retained academic responsibility for the study and publication.[9]
FMD · endothelial function
+2.9 percentage points
vs placebo at 6 months · pre-specified primary endpoint
Simple interpretation
“How responsive are the vessels?”
- NOVOS Core
- +2.6%
- Placebo
- −0.1%
- Adjusted difference
- +2.9 pp (95% CI 2.1–3.8)
PWV · arterial flexibility
−1.18 m/s
placebo-adjusted difference at 6 months
Simple interpretation
“How flexible are the vessels?”
- Placebo-adjusted
- −1.18 m/s
- 95% CI
- −2.00 to −0.36
- p value
- 0.006
Population studies suggest aortic PWV tends to increase by roughly ~1 m/s per decade of aging. This comparison describes the scale of the measurement.
A large meta-analysis found that every 1 m/s higher PWV was associated with approximately 14% higher total cardiovascular-event risk.[10] This epidemiologic association does not mean NOVOS Core has been shown to lower cardiovascular-event risk. The trial did not measure clinical cardiovascular events.
SBP · systolic blood pressure
−6.1 mmHg
placebo-adjusted difference · participants began and remained in the normal range
Simple interpretation
“How much pressure are the vessels experiencing with each heartbeat?”
- NOVOS Core
- −8.5 mmHg
- Placebo
- −1.5 mmHg
- Adjusted
- −6.1 mmHg
Large population studies have found that even a 2 mmHg difference in usual systolic blood pressure is associated with meaningful differences in vascular mortality.[11] The NOVOS Core trial did not evaluate heart attacks, strokes, mortality, or disease prevention, so population-level associations cannot be translated into a NOVOS Core disease-risk-reduction claim.
“The magnitude and consistency of these effects across multiple cardiovascular endpoints is unusual for a nutritional intervention in a healthy population.”
Professor of Cardiovascular Medicine · University of Surrey
Senior Author
Flow-mediated dilation · Core vs placebo
Change in FMD from baseline
Adjusted between-group difference at 6 months: +2.9 percentage points (95% CI 2.1–3.8), statistically significant versus placebo.[9]
Study measurement timepoints are not a promise of individual results. Values reflect change from baseline in flow-mediated dilation as reported in the SSRN preprint; manuscript currently under peer review.
An important detail
The vascular changes occurred without meaningful lipid changes.
The trial also measured cholesterol.
Lipid levels did not meaningfully change while FMD, PWV, and systolic blood pressure changed versus placebo.[9]
That is interesting because it suggests the observed vascular signal was not simply the consequence of lowering circulating cholesterol.
It also demonstrates why different measurements answer different questions. LDL-C and ApoB help characterize atherogenic exposure. FMD, PWV and blood pressure characterize aspects of vascular physiology. Both matter.
“Longevity supplement improves vascular aging markers in clinical trial”
Medical News Today · February 24, 2026[12]
Medical News Today interviewed both Professor Heiss and independent vascular surgeon Christopher Yi, MD, about the findings.
“The findings are genuinely intriguing and worth taking seriously as hypothesis-generating clinical evidence.”
Christopher Yi, MD · Board-Certified Vascular Surgeon
Why a multi-ingredient formula?
Vascular aging isn't one pathway.
These are ingredient rationale and biological context — not claims that the trial proved each mechanism.
Endothelial signaling
Vitamin C · Fisetin · Pterostilbene
Relevant to oxidative-stress and nitric-oxide biology.
Vascular tone
Magnesium · Glycine
Relevant to vascular tone, metabolic signaling, and redox biology.
Cellular energy
Calcium Alpha-Ketoglutarate · Malate
Central to mitochondrial and cellular-energy metabolism.
Inflammatory + stress signaling
Ginger · Rhodiola · L-Theanine
Studied in connection with inflammatory and stress-response biology.
Extracellular matrix
Hyaluronic Acid · Glucosamine
Relevant to extracellular matrix and connective-tissue biology.
The clinical trial tested the patent-pending finished formulation, not these ingredients individually. The study therefore cannot determine which ingredient, or combination of ingredients, was responsible for the measured effects.
Context, not competition
How does the magnitude compare with other interventions studied for the same markers?
These are not head-to-head trials. They are benchmarks from separately published studies and meta-analyses.
Sustained FMD benefit · percentage points
- NOVOS Core2.90
- Resistance training2.11
- Blueberries2.01
- CoQ101.69
- Nitric oxide booster1.60
- Folic acid1.51
- Resveratrol1.40
- Mediterranean diet1.30
- Aerobic exercise1.20
- Cocoa1.20
- Flavonoids1.15
- Severe weight loss1.10
- Walnuts1.05
- Flavan-3-ols1.02
- Omega-31.00
These were separately published studies, not head-to-head comparisons. Study populations, intervention durations, baseline health, measurement methods, and protocols differ. The chart is intended to contextualize the magnitude of reported biomarker changes, not to establish clinical superiority over exercise, diet, or other interventions.
Lifestyle measures such as exercise and heart-healthy diet have broad health benefits that extend far beyond these individual vascular biomarkers and remain foundational cardiovascular recommendations.
The pattern
Three independent functional markers moved in the same direction.
A single biomarker can move for many reasons.
The more interesting feature of the trial is the pattern.
The study found statistically significant placebo-adjusted differences across endothelial responsiveness, arterial flexibility, and systolic pressure in a generally healthy population.[9]
“Taken together, improvements across endothelial function, arterial flexibility, and systolic blood pressure point to a coherent pattern…”
Professor of Cardiovascular Medicine · University of Surrey
Senior Author
“That kind of consistency is not common in supplement trials, especially in adults without established cardiovascular disease.”
Board-Certified Vascular Surgeon
Quoted by Medical News Today
Yi noted that vascular aging can eventually contribute to hypertension, endothelial dysfunction, arterial stiffening, heart attack, stroke, kidney disease, and cognitive decline.[12]
“[NOVOS demonstrates] A willingness to engage in rigorous evaluation rather than shortcuts.”
Lead Physician · Longevity Medicine Program
Mayo Clinic Arizona
Dr. Kulick did not participate in the trial. Mayo Clinic neither conducted nor endorsed the study.
Where NOVOS Core fits
Lifestyle is the foundation.
Core is an additional layer.
No supplement replaces:
- Exercise
- A heart-healthy diet
- Adequate sleep
- Not smoking
- Managing blood pressure
- Managing atherogenic lipids
- Maintaining metabolic health
- Appropriate medical screening
And when a physician determines prescription medication is appropriate, a supplement should not be used instead.
But for people who already care about cardiovascular longevity, the NOVOS Core trial raises a compelling additional possibility: can a daily multi-pathway nutritional formula support vascular function even in people who are already generally healthy?
That is what this trial was designed to investigate. And across its three central functional vascular measures, the results were large and statistically significant versus placebo.
Clinically studied vascular-aging support
Support the system that supplies every other system.
NOVOS Core is a 12-ingredient longevity formula tested in a randomized, double-blind, placebo-controlled human trial in generally healthy adults 40+, with statistically significant placebo-adjusted differences across endothelial function, arterial flexibility, and healthy systolic blood pressure within the normal range.
The last word
The most important heart-health decision may be when you start caring about it.
For most healthy people in their 30s, cardiovascular disease feels distant.
That's precisely why the new guidelines matter.
The biology doesn't wait until symptoms appear. Neither should prevention.
Know the numbers that matter. Move. Eat well. Sleep. Don't smoke. Manage metabolic health. Use medication when your clinician determines that the evidence supports it.
And as cardiovascular science becomes better at measuring how blood vessels actually function, not merely whether disease has already appeared, we may gain more tools for supporting vascular health earlier.
NOVOS Core's first randomized human trial is one intriguing example.
It doesn't show that a supplement prevents heart attacks.
It does show something much narrower and scientifically interesting:
In generally healthy adults, a multi-pathway nutritional formula measurably changed how the vascular system functioned versus placebo.
And when the system being measured is responsible for delivering oxygen and nutrients to nearly every tissue in your body, that's worth paying attention to.
This article is for educational purposes only and is not intended to diagnose, treat, cure, or prevent cardiovascular disease or any other medical condition. Individual cardiovascular risk varies. Decisions regarding screening, medication, imaging, and treatment should be made with a qualified healthcare professional. NOVOS Core is a dietary supplement and is not a substitute for prescribed medical therapy.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
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Learn about NOVOS COREReferences
[1]American College of Cardiology / American Heart Association and partner societies. 2026 Guideline on the Management of Dyslipidemia. Circulation / Journal of the American College of Cardiology. Published March 13, 2026.
ACC/AHA clinical guidelinesPREVENT-ASCVD in adults ages 30–79, 10- and 30-year risk, Lp(a) at least once in adulthood, selective ApoB, selective CAC (men 40+, women 45+).
[2]AHA / ACC / American Diabetes Association / American Society of Nephrology. 2026 Clinical Guideline for Cardiovascular-Kidney-Metabolic (CKM) Syndrome. Circulation. Published June 2026.
AHA professional guidelinesWhole-body CKM framework: heart, kidney and metabolic health as one interconnected system.
[3]American Heart Association. Heart Disease and Stroke Statistics — 2026 Update. Circulation.
AHA statistical updateU.S. cardiovascular prevalence, hypertension prevalence, CKM risk in young and middle-aged adults, prevention statistics.
[4]Centers for Disease Control and Prevention, National Center for Health Statistics. Mortality in the United States — final 2024 data. NCHS Data Brief.
CDC/NCHS mortality data briefsHeart disease 683,491; cancer 619,876; stroke 166,852; Alzheimer's disease 116,022.
[5]World Health Organization. Cardiovascular diseases and the top 10 causes of death. WHO Fact Sheets.
WHO fact sheets19.8 million cardiovascular deaths in 2022 (~32% of global deaths); cancer and dementia comparisons come from different reporting years.
[6]American Heart Association. Dietary guidance to improve cardiovascular health. Circulation. 2021;144:e472–e487 (with current AHA dietary guidance).
DOI: 10.1161/CIR.0000000000001031Mediterranean-style eating as one heart-healthy dietary pattern.
[7]U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. HHS, Washington, DC.
health.gov physical activity guidelines150–300 minutes/week moderate or 75–150 minutes/week vigorous activity, plus muscle strengthening ≥2 days/week.
[8]Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health. Circulation. 2022;146(5):e18–e43.
DOI: 10.1161/CIR.0000000000001078Includes healthy sleep (7–9 hours for adults) among the eight cardiovascular health metrics.
[9]Piercy C, Harris J, Sackho K, Campagnolo P, Barardo D, Creagh-Brown B, Heiss C. Acute and 6-Month Vascular Effects of a Multi-Component Nutritional Supplement: A Randomised Controlled Trial. SSRN preprint. February 2026. Manuscript currently under peer review.
SSRN preprintUniversity of Surrey (STAMINA). ClinicalTrials.gov NCT06145087. 61 randomized, 43 completed, 6 months.
[10]Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2010;55(13):1318–1327.
DOI: 10.1016/j.jacc.2009.10.061Context only: each 1 m/s higher PWV was associated with ~14% higher total cardiovascular-event risk. Not a NOVOS Core risk-reduction claim.
[11]Lewington S, Clarke R, Qizilbash N, Peto R, Collins R (Prospective Studies Collaboration). Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults. The Lancet. 2002;360(9349):1903–1913.
DOI: 10.1016/S0140-6736(02)11911-8Context only for the population-level relationship between usual systolic blood pressure and vascular mortality.
[12]Medical News Today. “‘Longevity’ supplement improves vascular aging markers in clinical trial.” February 24, 2026.
Medical News TodayIndependent commentary from Professor Christian Heiss and vascular surgeon Christopher Yi, MD. Coverage is not an endorsement of NOVOS.
[13]Thijssen DHJ, Bruno RM, van Mil ACCM, et al. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. European Heart Journal. 2019;40(30):2534–2547.
DOI: 10.1093/eurheartj/ehz350FMD as a non-invasive measure of endothelial function.