Which blood tests matter most for a long life?
On this page
Start with two. ApoB counts the particles that carry cholesterol into your artery walls, and HbA1c shows your average blood sugar over the past two to three months. Put blood pressure beside them, even though it isn’t a blood test.
What we’d do
Ask for ApoB and HbA1c with your next panel. Repeat them every few months while you’re changing something, and once a year when they’re steady. Take your blood pressure at home for a week. Add other markers when there’s a reason, like a symptom or a question from your doctor, rather than buying the biggest panel on offer.
Why panels keep getting bigger
Longevity clinics and home kits sell panels with 50 or 100 markers, and more sounds better. But every extra number is another chance of a result just outside the normal range that may mean nothing, and the ones with the most evidence behind them can get lost in the pile.
ApoB: counting the particles
Cholesterol travels in the blood inside particles. The ones that can lodge in an artery wall, including LDL, each carry exactly one molecule of a protein called apolipoprotein B, or ApoB. So an ApoB test counts those particles.
Cholesterol can only get into the artery wall inside an ApoB particle, and how much builds up depends mostly on how many particles get trapped there, which depends on how many are in your blood. The usual LDL cholesterol test measures how much cholesterol the particles carry, and that amount varies from particle to particle. A 2019 review in JAMA Cardiology concluded that ApoB “unifies, amplifies, and simplifies” what the usual cholesterol tests say about risk.
The simple version
LDL cholesterol tells you how much cargo is on the road. ApoB counts the trucks. The trucks are what get stuck against the walls, so the count is what you want.
HbA1c: three months of blood sugar
A fasting glucose test is a snapshot of one morning. HbA1c shows your average blood sugar over the past two to three months. The American Diabetes Association uses these ranges:
| HbA1c | What it means |
|---|---|
| Under 5.7% | Normal |
| 5.7% to 6.4% | Prediabetes |
| 6.5% or higher | Diabetes |
These are diagnosis cut-offs. Your own target is something to set with your doctor, and the Gyroscope app personalizes yours.
Blood pressure: the one most people skip
It isn’t a blood test, but it belongs on the list. In a million adults, each 20 points of higher systolic pressure went with about twice the death rate from heart disease and stroke in middle age. And 4 in 10 Americans with high blood pressure don’t know they have it. See does blood pressure affect how long you live.
How often
Ask your doctor how often you need each one, and retest a few months after any change you make, so you can see whether it worked. For a DNA age test instead, see are biological age tests accurate.
4 sources
- Sniderman AD and others, Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review, JAMA Cardiology, 2019pubmed.ncbi.nlm.nih.gov
- American Diabetes Association, Understanding diabetes diagnosisdiabetes.org
- National Center for Health Statistics, Hypertension Prevalence, Awareness, Treatment, and Control Among Adults Age 18 and Older: United States, August 2021 to August 2023, Data Brief 511cdc.gov
- Lewington S and others, Age-specific relevance of usual blood pressure to vascular mortality, Lancet, 2002pubmed.ncbi.nlm.nih.gov
