Where to Start With Longevity: Begin With Your Heart

The short version

If you want more healthy years and do not know where to begin, begin with your heart. Heart disease is the leading cause of death in the US, it builds quietly for decades, and lowering LDL has some of the strongest evidence in medicine. Check your LDL, ApoB, and Lp(a), set a goal, and treat what sits above it.

Why the heart comes first

Heart disease is the leading cause of death in the US, according to the CDC.

It also starts early. In an autopsy study of young Americans who died of other causes, early plaque lesions were already present in every aorta and in more than half of the right coronary arteries of 15 to 19 year olds. How heart disease develops walks through the timeline. A heart attack is often the first sign of plaque that has built for years, which makes the early decades the best time to act.

The numbers worth knowing first

You can check each of these with a blood draw or a blood pressure cuff:

• LDL cholesterol, the cholesterol carried by the particles that build plaque.
• ApoB, a count of those particles. It catches risk LDL can miss.
• Lp(a), an inherited particle, high in about 1 in 5 people, that routine panels usually leave out. The 2026 guideline recommends testing it once.
• Blood pressure and blood sugar. Your primary care clinician covers these, and they belong on the list.

Your family history of early heart disease changes how soon and how hard to act. See heart disease in the family.

Why LDL has the strongest case

LDL is among the best-studied targets in medicine. A meta-analysis of 26 statin trials with about 170,000 people found that each 39 mg/dL drop in LDL-C cut major cardiovascular events about 22% and deaths from any cause about 10%.

Genetic studies and large cohorts point the same way, and show that the benefit grows the longer your LDL stays lower. A 2017 consensus statement from the European Atherosclerosis Society reviewed that evidence.

What to do this month

1. Get your numbers. Ask for a lipid panel, ApoB, and Lp(a) together. How to get an ApoB and Lp(a) test explains where.
2. Write down your family history of heart attacks, strokes, and high cholesterol.
3. Set a goal. Your clinician estimates your risk and picks an LDL and ApoB goal. How to lower LDL lists the 2026 goals by risk.
4. Choose the treatment that fits your gap. Food changes lower LDL about 10 to 15% for most people. Medicine closes larger gaps.
5. Recheck. A repeat test 4 to 12 weeks after any change shows whether the plan works.

Where lab panels and clinics fit

Services like Function Health and Superpower measure many markers across the body. That detail helps people who want a broad picture, and it works well next to treatment. Measuring does not lower LDL by itself, so a result above goal still needs a clinician who prescribes. Our comparison of Function Health alternatives lays out the differences.

How starting with Preval works

Preval Health coordinates care for one thing: high LDL and ApoB, using prescription medicine. We order your labs, so you need none to begin. A licensed clinician sets your goal, prescribes what fits, and rechecks a lipid panel and ApoB every quarter until you reach it. Membership is $99 a month, and medicines cost extra at cash prices.