Clinical Takeaway / TL;DR

Intervention	Key Finding	Evidence Level
Rosuvastatin	LDL-C lowering is causal and cumulative; Mendelian randomization shows lifelong exposure reduction yields ~3× greater CV risk reduction than late-start RCTs; WOSCOPS 20-year data: 21% lower CV mortality persisting 15 years after drug discontinuation	High
Ezetimibe	Second independent LDL-C–lowering pathway via NPC1L1 blockade; fully additive to statin at the mechanistic level; IMPROVE-IT confirmed CV event reduction beyond statin monotherapy — precisely what dual-mechanism Mendelian randomization predicted	High
Soluble Fiber	Third independent LDL-C–lowering pathway via bile acid sequestration (additive to statin + ezetimibe); blunts postprandial glycemia; feeds butyrate-producing microbiota; each 7g/day increment associated with 9% lower CV risk in pooled cohort data	High
Creatine Monohydrate	Augments phosphocreatine stores; improves strength and lean mass in older adults with resistance training; grip strength predicts CV mortality more strongly than blood pressure (Leong, Lancet 2015); cognitive signal emerging in older and sleep-deprived subjects	High (ergogenic); Moderate (cognitive)
Multivitamin-Multimineral	COSMOS-Mind: ~60% deceleration in cognitive aging vs. placebo. COSMOS epigenetic clocks substudy (Nature Medicine 2026): MVM slowed biological aging rate on PCGrimAge by 0.113 yr/yr and PCPhenoAge by 0.214 yr/yr — measurable deceleration of DNA methylation age	Moderate–High
Low-Dose Tirzepatide	GIP/GLP-1 dual agonism reduces visceral adiposity, insulin resistance, systemic inflammation; SELECT: 20% MACE reduction; Kang 2026: TZP restores M1/M2 macrophage homeostasis via KLF4/PPARγ, inhibits foam cell formation — anti-atherosclerotic effects partially independent of metabolic improvements	High (metabolic); Moderate (CV, extrapolated); Speculative (longevity)

Six interventions across six distinct primary mechanisms. Rosuvastatin and ezetimibe are listed separately because they operate on independent LDL-C pathways and their combination is mechanistically, not merely additively, motivated.