Longevity Medicine
What Biomarkers Matter Most for Longevity?
Last reviewed: May 2026 · Haute MD Editorial Team
The most predictive biomarkers for longevity include ApoB (the best individual predictor of cardiovascular risk), fasting insulin and HOMA-IR (metabolic health), hsCRP (systemic inflammation), Lp(a) (genetic cardiovascular risk factor), VO2 max (the strongest single predictor of all-cause mortality), testosterone and hormonal markers, and homocysteine (cardiovascular and cognitive risk). These go significantly beyond what standard annual physicals measure.
Cardiovascular biomarkers
ApoB replaces LDL-C as the most accurate measure of atherogenic particle burden. Lp(a) is a genetically determined cardiovascular risk factor in 20% of the population — cannot be treated with statins. Coronary artery calcium (CAC) score is the best imaging biomarker for cardiovascular risk stratification. hsCRP measures systemic inflammation strongly linked to cardiovascular events.
Metabolic biomarkers
Fasting insulin and HOMA-IR detect insulin resistance years before diabetes develops. HbA1c reflects average blood glucose over 3 months. Continuous glucose monitoring reveals glucose variability patterns invisible to spot tests.
Performance and functional biomarkers
VO2 max is the single strongest predictor of all-cause mortality and is highly modifiable with exercise. Grip strength is a validated predictor of mortality and functional independence. Balance, gait speed, and lean muscle mass are key functional biomarkers.
Frequently Asked Questions
What is ApoB and why is it better than LDL?
ApoB measures the total number of atherogenic lipoprotein particles. It is more accurate than LDL-C because two patients with the same LDL cholesterol can have very different particle numbers and therefore very different cardiovascular risk.
What is Lp(a) and should I have it tested?
Lp(a) is highly atherogenic and determined almost entirely by genetics. It is elevated in ~20% of the population. Every adult should know their Lp(a) — tested once since it does not change significantly over time.
What is a good VO2 max for longevity?
Most longevity physicians recommend targeting the 75th-90th percentile for your age group. For men at 40: excellent >52 ml/kg/min. For women at 40: excellent >46 ml/kg/min.
How do I improve my longevity biomarkers?
Zone 2 cardio and resistance training improve VO2 max, insulin sensitivity, and inflammatory markers. Dietary optimization addresses metabolic biomarkers. Quality sleep reduces inflammation. Specific medications target cardiovascular biomarkers when lifestyle is insufficient.
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Longevity Medicine · Miami Beach, FL
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Longevity Medicine · New York, NY
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Regenerative Medicine Specialist
Longevity Medicine · New York, NY
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