TL;DR: He looked healthy on the surface. Broad testing found high Lp(a), low HDL, above-optimal ApoB/LDL, and a major omega-3 gap — then Revi turned that into a clear priority list: what to log with his GP, what to improve, and what to retest.
This is a real Revi Longevity case study from a 37-year-old active man in the UK.
He took the test out of interest and found clear optimisation opportunities in cholesterol-carrying particles and inflammatory balance — alongside one raised inherited marker creating hidden cardiovascular risk he would not otherwise have known about.
This is the point of Revi: we test broadly, then identify what matters most, why it matters, and what to do first.
Summary
| 88.2 |
| Lipid & Heart 46.7 |
| Reduce cholesterol-carrying particles |
|
|
| 1. Discuss Lp(a) with your GP 2. Add omega-3 + shift fat quality 3. Build a Zone 2 base + cut alcohol |
| Omega-3 · soluble fibre · methylated B12 + folate · magnesium · beetroot (BP) |
| Liver, energy, recovery, immune system, blood sugar — a lean, fit build, clean liver & kidney function |
His inputs
Summarised for the case study — we capture significantly more than this when you're onboarded to Revi.
| 37, male, 6'3", 92.2 kg · BMI 25.4 · waist-to-height 0.47 |
| Blood pressure 134/73 · resting pulse 64 |
| Trains 5 h/week · 10 units alcohol/week · 7 h sleep · non-smoker |
His scores
Every system is scored against longevity-optimal — not just "in range." 100 = optimal; a lower score flags where there's the most to gain. Five of his eight systems are strong / optimal; one is the clear focus.
System | Score | Status |
|---|---|---|
| 46.7 | 🔴 Focus |
| 87.1 | 🟠 Opportunity |
| 88.1 | 🟠 Opportunity |
| 93.1 | 🟢 Strong |
| 95.1 | 🟢 Strong |
| 98.1 | 🟢 Optimal |
| 98.1 | 🟢 Optimal |
| 99.1 | 🟢 Optimal |
What the engine connected
Rather than flag markers one by one, the engine groups related markers into patterns and ranks them by opportunity — how big and how real the gap is. Scored on the same 0–100 scale as the systems (higher = closer to optimal), so the lowest score is where the work is.
What the engine connected | Score | Strength | Flagged markers |
|---|---|---|---|
| 57.0 | 🔴 Biggest | Lp(a), ApoB, LDL, total cholesterol |
| 82.7 | 🟠 Present | Omega-3 index, AA:EPA ratio, EPA |
| 92.6 | 🟠 Present | Adiponectin, uric acid, glucose |
| 93.1 | 🟠 Present | hs-CRP, white cells |
| 95.8 | 🟡 Emerging | Systolic BP, resting pulse |
The two most significant findings
These are the markers behind the two findings that matter most, shown against their clinical reference range. 🔴 = outside
reference · 🟠 = in range but short of optimal.
Finding 1 — Cholesterol-carrying particles (atherogenic lipid pattern)
His standout marker is Lipoprotein(a): an inherited cholesterol-carrying particle more than double the lab reference threshold.
Lp(a) is not included in a standard lipid panel and is largely genetically determined, so this is less about “fixing” Lp(a) directly and more about knowing the baseline risk early.
The practical goal is to log it with his GP, consider whether further cardiovascular risk assessment is appropriate, and optimise everything around it: ApoB, LDL, blood pressure, omega-3 status, alcohol, aerobic fitness and inflammation.
Omega-3 will not meaningfully lower Lp(a); the goal is to improve the modifiable cardiovascular risk factors around an inherited Lp(a) signal.
Marker | His result | Reference range | Status |
|---|---|---|---|
| 167.7 nmol/L | under 75 | 🔴 ↑ above reference |
| 1.41 mmol/L | 1.55–2.5 | 🔴 ↓ below reference |
| 74 mg/dL | 49–173 | 🟠 within range, above optimal |
| 2.51 mmol/L | under 3.0 | 🟠 within range, above optimal |
| 4.31 mmol/L | under 5.0 | 🟠 within range, above optimal |
Finding 2 — Omega-3 & essential fats
Omega-3s are marine fats found in oily fish. They support cardiovascular health and are involved in inflammatory signalling, cell membranes and brain function.
His Omega-3 Index is below the reference floor, and his AA:EPA ratio is nearly double the top of range — a clear omega-3 gap. This is one of the most modifiable findings in his report and can be moved with diet, supplementation and retesting.
Marker | His result | Reference range | Status |
|---|---|---|---|
| 6.87 % | 7.99–12 | 🔴 ↓ below reference |
| 19.5 | 2.49–11.11 | 🔴 ↑ above reference |
| 0.85 % | 0.25–4.5 | 🟠 within range, below optimal |
His top 3 actions
═══════════════════════════════════════════════════════
Priority 1 — Discuss Lp(a) with your GP
GP Priority
Why: Lipoprotein(a) is significantly above its reference range and inherited — it's largely genetically determined and not meaningfully lowered by lifestyle. This is not an emergency, but it raises lifetime cardiovascular risk, so it's worth logging with a GP, asking whether a CAC (coronary calcium) scan is useful for context, and noting that first-degree relatives may consider testing.
Affects (Lipid & Heart): Lipoprotein (a)
═══════════════════════════════════════════════════════
Priority 2 — Add omega-3 and shift fat quality
Biggest multiplier
Why: His Omega-3 Index is below reference range and his AA:EPA ratio is above range, while ApoB, LDL and total cholesterol sit above Revi optimal and HDL is below range. The highest-leverage first move is to close the omega-3 gap while improving fat quality and soluble fibre intake, then retest the lipid and fatty-acid response.
Affects (Lipid & Heart): Omega-3 Index · AA:EPA ratio · Apolipoprotein B · LDL Cholesterol · Total Cholesterol · HDL Cholesterol
═══════════════════════════════════════════════════════
Priority 3 — Build a Zone 2 base and cut alcohol
Cross-system driver
Why: His HDL is below range, systolic blood pressure is mildly elevated at 134/73, and adiponectin and uric acid suggest room to improve metabolic flexibility. Zone 2 training plus reducing alcohol are cross-system levers: they can support protective cholesterol, blood pressure, inflammation, recovery and fuel use over time.
Affects (Lipid & Heart · Metabolic): HDL Cholesterol · Adiponectin · Uric Acid · Resting Pulse
Which supplements to add — and why
Each chosen for a specific gap in his bloodwork — framed for diet, tolerance and GP advice, not a blanket stack.
In a Revi report, you are given the supplement, dose, timing and reason — where supplementation is appropriate.
Supplement | Why — the gap it closes | Tier |
|---|---|---|
| Omega-3 Index 6.87% (below reference), AA:EPA 19.5 (above range), EPA low — his biggest gap; supports the lipid and inflammation picture | Foundational |
| ApoB, LDL and total cholesterol above optimal — first-line soluble-fibre lever to lower particle burden | Tier 1 |
| B12 and folate below optimal, homocysteine above optimal — closes the methylation gap | Tier 1 |
| Magnesium 0.82 (below optimal 0.85–0.95) — a modest gap; supports recovery and sleep | Conditional |
| Blood pressure 134/73 — Optional: nitrate-rich vegetables or beetroot extract may support systolic blood pressure in some people. | Conditional |
His plan — by priority area
Grouped by what the engine flagged. Each area: what fired + an Action / Exactly-what-to-do table.
1 · GP — Lp(a) (inherited cardiovascular risk)
What fired: Lp(a) 167.7 (above 75) — inherited, fixed for life.
Action | Exactly what to do |
|---|---|
See your GP (priority) | Log the Lp(a) result. Ask whether a CAC (coronary calcium) scan is useful for context, and whether your overall cardiovascular risk warrants any follow-up. Lp(a) is largely genetically determined and not meaningfully lowered by lifestyle — this is about knowing your baseline. |
Family awareness | Lp(a) is genetic — first-degree relatives may consider testing. |
Focus the modifiable levers | Since Lp(a) can't be lowered by lifestyle, put the energy into everything else that is modifiable (areas 2–6). |
Monitor | No routine retest for Lp(a) itself; track the modifiable lipids instead. |
2 · Focus — Cholesterol-carrying particles (fat quality + fibre)
What fired: ApoB 74, LDL 2.51, total cholesterol 4.31 above optimal; HDL 1.41 below reference.
Action | Exactly what to do |
|---|---|
Improve fat quality | Extra-virgin olive oil 1–2 tbsp/day; oily fish (salmon, mackerel, sardines) 2–3×/week, 140 g portions; cut butter, processed meat and full-fat dairy. |
Increase soluble fibre | Build to 30–40 g/day (≥10 g viscous): 40–60 g rolled oats at breakfast + 150 g cooked lentils or black beans at lunch + psyllium each evening. Build up over 2 weeks. |
Psyllium husk (supplement) | 1 tbsp (~5 g) in a large glass of water each evening, from week 1 → twice daily after 2 weeks if tolerated. Always with a full glass of water; space ≥2 h from any medications. |
Monitor | ApoB, LDL and total cholesterol trending toward optimal by 8–12 weeks. |
3 · Optimisation — Omega-3 (close the gap)
What fired: Omega-3 Index 6.87 (below reference), AA:EPA 19.5 (above range), EPA below optimal.
Action | Exactly what to do |
|---|---|
Eat more oily fish | Salmon, mackerel or sardines 2–3×/week, 140 g — the primary lever; raises the Omega-3 Index and pulls the AA:EPA ratio down. |
Omega-3 supplement | EPA/DHA ~2 g/day — given how far below reference the index sits, a supplement is warranted alongside diet. |
Monitor | Repeat Omega-3 Index and AA:EPA ratio at 12 weeks to confirm response. |
4 · Focus — Protective cholesterol & aerobic base (Zone 2 + alcohol)
What fired: HDL 1.41 below reference; adiponectin, uric acid short of optimal; alcohol 10 u/week.
Action | Exactly what to do |
|---|---|
Build a Zone 2 base | 3–4 sessions/week, 45–60 min, conversational pace (60–70% max HR) — cycling, incline walking or rowing. Supports aerobic fitness, metabolic flexibility and the protective cholesterol pattern over time. |
Reduce alcohol | From ~10 to ~5 units/week — improves HDL, uric acid, inflammation and sleep. |
Monitor | HDL and metabolic flexibility markers — adiponectin and uric acid moving by 8–12 weeks. |
5 · Try — Blood pressure
What fired: clinic BP 134/73 — mildly elevated.
Action | Exactly what to do |
|---|---|
Confirm at home | 7 days of home blood-pressure readings, twice daily, to get a true baseline before any conversation. |
Beetroot / nitrate | Nitrate-rich vegetables or beetroot extract may support systolic blood pressure in some people. First confirm a true baseline with home readings. |
Lifestyle | The Zone 2, alcohol reduction and fat-quality changes above all support blood pressure. |
Monitor | Home BP trend over 2–4 weeks. |
6 · Optimisation — Methylation & nutrients (B12, folate, magnesium)
What fired: homocysteine 11 above optimal; active B12 51.8, folate 11.5, magnesium 0.82 below optimal.
Action | Exactly what to do |
|---|---|
Methylated B12 + folate | Active B12 + methylfolate (methylated forms) — closes the methylation gap (homocysteine). Food-first plus a low-dose supplement. |
Magnesium | Glycinate or threonate (avoid oxide), 200–400 mg elemental, evening ~30 min before bed. Foods: pumpkin seeds, spinach, almonds, black beans. |
Folate foods | 90 g cooked spinach or 150 g lentils, 3–4×/week. |
Monitor | Homocysteine, B12, folate and magnesium at 8–12 weeks. |
Revi — the Longevity Decision Engine. Most blood tests give you numbers. Revi tells you what matters most, why, and what to do first.
This case study is for educational purposes and is not medical advice. Findings are patterns to discuss with a qualified clinician, not diagnoses. Shared with the client's permission; some details summarised for privacy.
Cris Hesketh
Founder, Revi Longevity
revilongevity.com
