This is a tough question to really answer. I have seen a 60 year old guy on another forum who stays on years straight with 500 test, 1g primo, trestalone, halo, gh, and a few other items. He also has a very labor intensive job which i am sure aids in his cardiovascular health. He has had blood work done and health markers are in check.
Then we recently had the passing of Matt Porter, who was running 500 mg of test a week, health markers were in range, BUT... he did have an existing heart condition, and passed away suddenly. I can not recall if the heart condition was from the gear or not. I also am unsure if the test usage exacerbated the issue.
From a personal level, i went and got an echocardiogram done not to long ago, due to the fact i've been running Gh for about 1.5 years at that point and abusing aas for roughly the last 2 years. The Dr there said, oh, you're on trt, you should be getting this done anyway, not just cause of the other things you're doing.
I really feel this is all a case by case basis. Just like if ran all that gear with no AI, I'd have tits like Dolly Parton.
We all process things different, but i would venture to say that the amount your friend is doing will have some sort of impact on his health. Maybe not now, next year, or even 5 years.
Like you i try to steer my friends into getting blood work done and to monitor their blood pressure. They don't listen. I just tell em well if ya change your mind lemme know, and i'll show ya how to order it , and from where.