The best blood tests for longevity: what's worth measuring?

The 2026 cholesterol guidelines recommend a blood test that most adults only need once: lipoprotein(a), or Lp(a). It measures an inherited risk factor for heart disease that a standard cholesterol panel misses.

Before buying a longevity blood panel, ask: what would I do differently with the results? A useful test helps you choose a treatment or check whether it’s working. Predicting illness doesn’t establish that changing a test result will prevent it.

This guide covers blood tests that can help prevent heart disease and diabetes, when to consider additional tests, and what to do with the results.

Which blood tests are most useful for longevity?

Lipid panels, ApoB, Lp(a), and blood sugar tests answer different questions:

Test	What it tells you	Who should consider it	What it can change
Lipid panel	Cholesterol and triglyceride levels	Adults assessing cardiovascular risk	Nutrition and cholesterol-lowering treatment
ApoB	Concentration of plaque-forming particles	Selected patients, including some with diabetes or high triglycerides	Whether to start or intensify cholesterol treatment
Lp(a)	An inherited cardiovascular risk factor	Every adult, at least once	How aggressively to manage other heart disease risks
HbA1c or fasting glucose	Whether blood sugar is elevated	People eligible for diabetes screening	Diabetes prevention or treatment

The US Preventive Services Task Force recommends diabetes screening for adults ages 35–70 who have overweight or obesity. Other risk factors can justify earlier screening.

Lipid panel: a starting point for preventing heart disease

A lipid panel measures total cholesterol, HDL cholesterol, and triglycerides, and usually reports LDL cholesterol. Non-HDL cholesterol is total cholesterol minus HDL. It captures cholesterol carried by a broader group of particles that contribute to plaque.

The 2026 guidelines set lower LDL and non-HDL goals for people at higher cardiovascular risk. Someone who’s had a heart attack needs a different treatment plan from someone with the same LDL level and no cardiovascular disease.

Ask your doctor which cholesterol goal applies to you, how to reach it, and when to retest.

ApoB vs. LDL cholesterol: what does each measure?

LDL cholesterol measures the cholesterol inside LDL particles. Apolipoprotein B, or ApoB, reflects the number of plaque-forming particles in your blood. Each carries one ApoB molecule, but the amount of cholesterol inside varies.

Two people can have similar LDL cholesterol and different ApoB levels. When the measures disagree, ApoB can reveal risk that LDL alone understates, as the National Lipid Association’s consensus explains.

The 2026 guidelines support ApoB testing in selected patients, including those with diabetes, high triglycerides, or very low LDL on treatment. It can help determine whether cholesterol treatment needs to be intensified.

Read more about ApoB versus LDL cholesterol.

Lp(a): a blood test most adults only need once

Lipoprotein(a), pronounced “L-P-little-a,” is a cholesterol-carrying particle whose level is largely inherited. It can be elevated even when your standard cholesterol results look reassuring. Diet and exercise generally have little effect on Lp(a), and frequent repeat testing usually adds little.

The American Heart Association recommends testing every adult at least once. A high result can lead to closer management of LDL and blood pressure, and testing of close relatives.

Our Lp(a) guide explains how to interpret the result.

HbA1c or fasting glucose: finding diabetes risk early

Hemoglobin A1c, or HbA1c, estimates average blood sugar over roughly three months without requiring a fast. Fasting glucose measures blood sugar at the time of the draw, after an overnight fast.

An A1c of 5.7%–6.4% is in the prediabetes range; 6.5% or higher is in the diabetes range. Without symptoms, an abnormal result generally needs confirmation. Anemia and other conditions that affect red blood cells can make A1c misleading, so a clinician may use a glucose test instead. NIDDK’s A1c guide explains these limitations.

In the Diabetes Prevention Program, an intensive lifestyle program reduced progression to type 2 diabetes by 58% relative to placebo over about three years. Participants were at high risk and worked toward weight loss and physical activity goals.

If your result is elevated, work with your clinician on a plan for food, exercise, weight management when appropriate, and sometimes medication. Set a date to retest.

Which additional blood tests are worth considering?

If you have diabetes or high blood pressure, kidney testing can identify another risk. Blood creatinine helps estimate how well your kidneys filter blood, reported as eGFR. A urine albumin-to-creatinine ratio checks for kidney damage that a blood test alone can miss.

High-sensitivity C-reactive protein, or hs-CRP, measures inflammation. The 2026 cholesterol guideline says persistent elevation can help a doctor decide whether to prescribe a statin for someone with borderline estimated cardiovascular risk. The recommendation requires elevation on two occasions without an identifiable underlying cause. One high result during an illness doesn’t establish persistent elevation.

Vitamin D testing may be appropriate for your symptoms or medical history, but the USPSTF found insufficient evidence to determine whether screening adults without symptoms improves health.

How to choose a longevity blood panel

Before ordering, ask who will interpret the results and arrange follow-up. Does the price include a clinician visit, treatment, or repeat testing?

Your doctor should interpret the results alongside your blood pressure, smoking history, medications, family history, and previous tests.

Leave the visit knowing which risk you’re addressing, what you’ll do, and when you’ll check whether it worked. For high LDL, that might mean changing your diet or starting medication, then repeating the test to see whether you’ve reached your goal.