Cardiovascular Disease as Coupled Regulatory Erosion: A Framework for Earlier Detection, Targeted Intervention, and Reduced Health System Burden

Abstract Cardiovascular disease is the leading cause of death globally, killing approximately 18 million people per year. This white paper and research programme applies the SymbioMind Integrative Practice (SIP) theoretical framework to cardiovascular disease, proposing that the acute cardiovascular event is the terminal expression of decades-long coupled inflammatory decoherence across nine regulatory domains. The paper makes four contributions: (1) identification of inflammatory decoherence as the hypothesised central attractor state, formalised through the GTRS regulatory ratio; (2) a nine-node coupling topology with an explicit evidence gradient distinguishing demonstrated, emerging, and hypothetical coupling pathways based on 92 studies including cross-lagged panel models, bidirectional Mendelian randomisation, and mediation analyses; (3) transfer of the bifurcation-point architecture from acute infectious disease to chronic cardiovascular disease across multiple timescales; and (4) peripheral observable indicators proposed as hypothesis-generating early-warning signals with pre-registered null hypotheses. The document is structured for multiple audiences: an executive white paper for health policy decision-makers, the full scientific paper for research teams, five implementation-ready research protocols with statistical specifications for biostatisticians, and a theoretical reference guide. All materials are CC BY-NC 4.0. HATI³ adversarial evaluations score the work at 77–86/100, classification: fundamentally sound.