Vlad theorycrafting

Ever since I first played Vlad, I was intrigued by his E ability, Tides of Blood. It's a full AoE (i.e it hits everyone) with a pretty good range (620). It has a stupidly low cooldown (4.5 seconds unbuffed) and gives you a 10 second buff that stacks 4 times. That buff makes the spell do 25% more damage (per stack), the spell COST 25% more health and your health regen increase by 8%.

Here's the thing about Vlad, his passive really incentives having a giant health pool. It's not unreasonable for him to have 3500+ health at full build and he'll have 2k at a fairly early stage of the game. Throwing something like Warmog's and Spirit Visage on him makes certain that he'll have beefy regen as well.

So it got me thinking, at what point in the game should you just walk around spamming your E ability because, over the next 10 seconds, you're going to regen the health anyways?

Let's assume that we're not l33t pros and we can't cast the spell EXACTLY every 10 seconds. Assuming we cast it every 9, that means we're going to be spending 70 * (1+4*.25) = 140 health every 9 seconds. We need our HP/5 to be at 156 or better to payoff. As it turns out, Warmog's and Spirit Visage take care of that problem by themselves (with a full stack of Warmog's buff)

Realistically, Spirit Visage and the Warmog's buff aren't really necessary. Your Q ability has a lifedrain and, most Vlad builds have a spell vamp (through either Hextech or Will of the Ancients).

So the answer is, as soon as you get your Warmog's (or Leviathan or whatever), spam the E button. It's net positive for you and a terror for your enemies.