After 45, your body starts sending signals — some obvious, some silent. The good news is that a handful of simple, widely available tests can give you an accurate picture of where you stand and, more importantly, what to do about it.
You don’t need an expensive concierge health programme or a stack of supplements to get started. You need a short list of reliable numbers, tracked consistently over time. This checklist covers the six tests that longevity researchers and clinicians most consistently recommend for adults over 45.
Bring this list to your next check-up, log your results, and focus on trends rather than one-time readings. Small, informed adjustments — in sleep, movement, and nutrition — can make a measurable difference over the years ahead.
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1. Blood Pressure
Why It Matters
High blood pressure (hypertension) is one of the most significant risk factors for heart disease, stroke, and kidney damage — and it is often called the “silent killer” because it produces no noticeable symptoms for years. The American Heart Association estimates that nearly half of adults have high blood pressure, yet many are unaware of it.
What to Track
- Target range: ~120/80 mmHg (individual targets may vary based on age and health history)
- Elevated: 120–129 systolic with less than 80 diastolic
- High Blood Pressure Stage 1: 130–139 / 80–89 mmHg
How Often
At least once per year at your annual check-up. If your readings are elevated, your clinician may recommend monthly home monitoring. Home blood pressure monitors are inexpensive and widely available.
2. Lipid Panel (Cholesterol)
Why It Matters
A lipid panel measures the fats circulating in your blood and is a primary tool for assessing cardiovascular risk. High LDL cholesterol, in particular, is strongly associated with the buildup of arterial plaque — a process that accelerates with age and is directly linked to heart attack and stroke risk. This is one of the most actionable tests available because diet, exercise, and medication can all move these numbers significantly.
What to Track
- LDL (“bad” cholesterol): Aim for under 100 mg/dL; under 70 mg/dL if you have existing cardiovascular risk factors
- HDL (“good” cholesterol): Higher is better; aim for above 60 mg/dL
- Triglycerides: Aim for under 150 mg/dL
How Often
Every one to two years for most adults over 45, or more frequently if you have elevated readings or a family history of cardiovascular disease. A standard lipid panel requires a fasting blood draw, so schedule it for the morning.
3. Blood Sugar (Fasting Glucose / HbA1c)
Why It Matters
Blood sugar regulation is central to metabolic health and longevity. Chronically elevated blood sugar accelerates cellular aging, damages blood vessels and nerves, and is the defining feature of type 2 diabetes — a condition that significantly increases the risk of heart disease, kidney failure, and cognitive decline. The critical window is prediabetes: a reversible state that affects roughly one in three adults over 45 and is almost entirely symptom-free. Catching it early through regular testing is one of the highest-leverage health actions you can take. For a deeper look at metabolic markers, see our guide on healthspan vs. lifespan.
What to Track
- Fasting glucose: Normal is under 100 mg/dL; 100–125 mg/dL indicates prediabetes
- HbA1c: Reflects your average blood sugar over the past 2–3 months. Normal is under 5.7%; 5.7–6.4% is prediabetes
How Often
Every one to three years depending on your risk profile. If you are overweight, have a family history of diabetes, or lead a sedentary lifestyle, annual testing is advisable. HbA1c can be done without fasting, making it a convenient add-on to any blood draw.
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4. Waist Circumference and Body Composition
Why It Matters
Body weight alone is a poor predictor of health risk. What matters far more is where fat is stored. Visceral fat — the fat that accumulates around the abdominal organs — is metabolically active in a harmful way. It releases inflammatory compounds, disrupts insulin signalling, and is independently associated with cardiovascular disease, type 2 diabetes, and certain cancers. A tape measure is one of the most underrated health tools you own. Pairing this with a strength training programme is one of the most effective ways to reduce visceral fat over time.
What to Track
- Waist circumference: Risk increases above 35 inches (88 cm) for women and 40 inches (102 cm) for men
- Waist-to-height ratio: A ratio below 0.5 is a useful general target
- Weight trends: Secondary; track direction over months, not day-to-day fluctuations
How Often
Monthly or quarterly. This is one measurement you can do at home at no cost. Measure at the same time of day (morning, before eating) and in the same location — at the level of your navel — for consistent results.
5. Kidney Function (Creatinine / eGFR)
Why It Matters
The kidneys filter roughly 200 litres of blood per day, removing waste and regulating fluid balance. Kidney function declines gradually and silently with age — and the decline is accelerated by high blood pressure, diabetes, and certain medications. By the time symptoms appear (fatigue, swelling, changes in urination), significant damage may already have occurred. Catching a decline early allows for dietary and lifestyle changes that can slow or halt progression.
What to Track
- Creatinine: A waste product filtered by the kidneys; elevated levels suggest reduced kidney function
- eGFR (estimated glomerular filtration rate): The key number. An eGFR above 60 is generally considered normal; below 60 warrants monitoring and specialist review
How Often
Every one to two years as part of a standard metabolic panel. If you have diabetes, high blood pressure, or a family history of kidney disease, annual testing is recommended. Both markers are typically included in a routine blood test ordered by your GP.
6. Inflammation Marker (hs-CRP)
Why It Matters
Chronic low-grade inflammation — sometimes called “inflammaging” — is now understood to be a central driver of the diseases of ageing, including heart disease, Alzheimer’s, type 2 diabetes, and certain cancers. High-sensitivity C-reactive protein (hs-CRP) is a blood marker that reflects systemic inflammation levels. Unlike acute CRP (which spikes during infection), hs-CRP measures the chronic, smouldering inflammation that does long-term damage. It is one of the more actionable markers because lifestyle changes — particularly improving sleep, reducing processed food intake, and increasing physical activity — can lower it meaningfully. For more on how inflammation connects to ageing, see our article on how cortisol ages you.
What to Track
- hs-CRP under 1.0 mg/L: Low cardiovascular risk
- hs-CRP 1.0–3.0 mg/L: Moderate risk; worth addressing with lifestyle changes
- hs-CRP above 3.0 mg/L: High risk; discuss with your clinician
How Often
Periodically, based on your risk profile. hs-CRP is not always included in a standard panel, so you may need to request it specifically. It is most useful as a baseline and then as a way to measure the impact of lifestyle changes over six to twelve months.
How to Use This Checklist
The value of these tests is not in any single reading — it is in the trend. A one-time cholesterol result tells you relatively little. The same result tracked annually over five years tells you whether your lifestyle is working. Here is a simple system for getting the most out of these six markers.
- Bring this list to your next check-up. Ask your clinician which of these tests you are already due for and request any that are missing from your usual panel.
- Create a simple tracking log. A spreadsheet with six columns (one per test) and a new row for each year is all you need. Date, result, and any notes on lifestyle changes at the time.
- Focus on trends, not single readings. A slightly elevated LDL in one test is not a crisis. A consistently rising LDL over three years is a signal worth acting on.
- Combine with simple habits. These numbers respond to sleep quality, daily movement, and dietary choices. Improving one area often improves several markers simultaneously. For a practical framework, see our guide on building a morning routine for longevity.
Frequently Asked Questions
Do I need all six tests at every check-up?
Not necessarily. Blood pressure and waist circumference can be checked at every visit. The blood tests (lipid panel, blood sugar, kidney function, hs-CRP) are typically done annually or every one to two years depending on your risk profile. Your clinician will advise on frequency based on your results and history.
Can I get these tests done without a GP referral?
In many countries, including Canada and the US, private lab testing services allow you to order blood panels directly without a physician referral. This can be useful for tracking between annual check-ups. However, always discuss abnormal results with a qualified clinician before making significant changes.
What is the most important test on this list?
There is no single “most important” test — they each measure different systems. That said, blood pressure and blood sugar are the two most commonly missed and most actionable. If you have not had either checked recently, those are the logical starting points.
How quickly can lifestyle changes affect these numbers?
It varies by marker. Blood pressure can respond to dietary changes (particularly reducing sodium and increasing potassium) within weeks. HbA1c reflects a three-month average, so meaningful changes take at least that long to show up. Lipid panels typically show meaningful change after three to six months of consistent dietary and exercise changes.
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Not medical advice. Consult your clinician for personal medical decisions.