Which blood tests are worth getting after 40?
After 40, the blood tests with the strongest guideline support are a cholesterol panel to estimate heart risk, a one-time lipoprotein(a) test, an A1c or glucose test if you carry extra weight, kidney tests if you have diabetes, high blood pressure or heart disease, and a one-time hepatitis C test. ApoB and hsCRP help in some cases. Biological age tests aren't ready for the clinic yet.
Reviewed by Darshan Patel, MD, Obesity medicine physician, on 2026-11-12. Next review 2027-05-11.
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Your numbers after 40
Forty is when a lot of people start asking a good question: what should I be checking so I can stay healthy for decades? The answer is reassuring. A handful of standard blood tests, most of them simple and familiar, tell you a great deal about your heart, blood sugar and kidneys. They also point to steps you can take this year.
This guide sorts the tests into three groups: the ones guidelines back, the ones that help in some cases, and the trendy ones that add little for people who feel well.
The core tests guidelines back
| Test | What it tells you | Who, per guidelines | How often |
|---|---|---|---|
| Cholesterol (lipid) panel | LDL and other cholesterol numbers, which go into the calculators doctors use to estimate your 10-year risk of heart attack and stroke | The 2026 ACC/AHA guideline's PREVENT calculator is built for adults 30 to 79. The USPSTF uses 10-year risk to decide on statins for adults 40 to 75 | With your regular checkups |
| Lipoprotein(a), or Lp(a) | A mostly inherited cholesterol particle linked to heart disease and stroke risk | Every adult | At least once in adulthood |
| A1c or fasting glucose | Whether you have prediabetes or type 2 diabetes | Adults 35 to 70 with overweight or obesity (BMI 25 or higher, or 23 or higher for Asian Americans) | Every 3 years may be reasonable if normal |
| Kidney function (blood) and urine albumin | How well your kidneys filter your blood, and whether there is albumin in your urine | People with diabetes, high blood pressure, heart disease or a family history of kidney failure | Every year if you have diabetes; ask about timing otherwise |
| Hepatitis C | Whether you have hepatitis C virus infection | Adults 18 to 79 | Once for most adults |
Early kidney disease usually has no symptoms, which is why testing matters when you have a risk factor.
Tests that help in some cases
- ApoB. Another cholesterol-related marker of heart risk. The 2026 ACC/AHA guideline suggests it for checking remaining risk in people with type 2 diabetes, high triglycerides, known heart disease or cardiovascular-kidney-metabolic syndrome who have reached their LDL goals. For many other people, a standard panel and Lp(a) cover the basics.
- hsCRP (high-sensitivity C-reactive protein). The ACC/AHA guideline lists it among markers that can refine your risk estimate. The US Preventive Services Task Force found too little evidence to add it to routine risk checks for everyone.
- Coronary artery calcium scan. Not a blood test, but people often ask. The ACC/AHA guideline suggests it selectively for men 40 and older and women 45 and older whose 10-year risk is borderline or intermediate, when the risk estimate is uncertain.
Popular tests that add little if you feel well
These can be useful when you have symptoms or a related condition. As routine screens for people who feel well, the evidence is thin.
- Vitamin D. The US Preventive Services Task Force found too little evidence to recommend screening adults without symptoms.
- Thyroid. Same finding for screening adults without symptoms.
- Biological age tests. Epigenetic clocks and similar tests are still being studied. Experts haven't agreed on how they should be validated before they're used in the clinic.
Your numbers, read by a physician
A lab report is only useful when someone helps you act on it. If your results point to weight, blood sugar, blood pressure or cholesterol, that's exactly where our physicians focus.
- Aayu Elevate™: video visits with an obesity medicine physician, a registered dietitian, and medicine when it's right for you.
- Aayu Elevate Plus™: everything in Elevate, plus care for common conditions such as depression, anxiety and sleep problems.
Bring the results you already have. Your physician will tell you which ones are fine, which need a closer look, and what to check next. Most major insurance accepted, plus convenient cash pay options. Book my consultation
Questions to bring to your visit
- What is my 10-year risk of heart attack and stroke, and what's my LDL goal?
- Have I ever had an Lp(a) test?
- Should I be checked for prediabetes or kidney disease?
- Is ApoB, hsCRP or a calcium scan worth it for me?
- Could a GLP-1 medicine help my numbers? See GLP-1s as longevity medicine.
Good to know
- A single result is one piece of the picture. Your physician reads it alongside your blood pressure, family history and the medicines you take.
- Guidelines change. This page follows the 2026 ACC/AHA cholesterol guideline and current US Preventive Services Task Force recommendations, and we review it at least every six months. How we review our guides.
- Wondering about peptides or NAD+ for healthy aging? Our peptide guide grades the evidence, and our healthy aging guide covers the habits with the strongest evidence.
Questions people ask
Can an Aayu Well physician order and review these tests?
Yes. In a video visit, your physician goes over the results you already have, orders the tests that fit your age, history and goals, and explains what the numbers mean for you.
Should everyone get a lipoprotein(a) test?
The 2026 ACC/AHA cholesterol guideline says Lp(a) should be measured at least once in adulthood. It's mostly inherited and stays fairly stable, so one test is usually enough.
Is ApoB better than LDL cholesterol?
For some people. The 2026 ACC/AHA guideline says ApoB may be used to check remaining risk in people with type 2 diabetes, high triglycerides, known heart disease or cardiovascular-kidney-metabolic syndrome who have already reached their LDL and non-HDL cholesterol goals. In those groups it may be a more accurate marker than LDL.
What LDL number should I aim for?
It depends on your risk. The 2026 ACC/AHA guideline sets goals of less than 100 mg/dL for borderline or intermediate risk, less than 70 for high risk, and less than 55 for people who already have cardiovascular disease. Your physician can tell you which goal fits you.
Do I need a vitamin D or thyroid test?
Not as a routine screen if you feel well. The US Preventive Services Task Force found too little evidence to say whether screening adults without symptoms helps. If you have symptoms or a related condition, your physician may still test.
Are biological age tests worth it?
Not yet. Experts haven't agreed on how these tests should be validated before they're used in the clinic, so results are hard to act on.
Turn your numbers into a plan
In one video visit, an obesity medicine physician goes over the results you already have, decides with you which tests make sense next, and explains what your numbers mean for your heart, blood sugar and kidneys. Most major insurance accepted, plus convenient cash pay options.
Sources
- American College of Cardiology: ACC/AHA issue updated guideline for managing lipids, cholesterol (2026 dyslipidemia guideline, JACC and Circulation, March 13, 2026)
- US Preventive Services Task Force: Statin use for the primary prevention of cardiovascular disease in adults (August 23, 2022)
- US Preventive Services Task Force: Screening for prediabetes and type 2 diabetes (August 24, 2021)
- NIDDK: Chronic kidney disease tests and diagnosis
- US Preventive Services Task Force: Screening for hepatitis C virus infection in adolescents and adults (March 2, 2020)
- US Preventive Services Task Force: Cardiovascular disease risk assessment with nontraditional risk factors (July 10, 2018)
- US Preventive Services Task Force: Screening for vitamin D deficiency in adults (April 13, 2021)
- US Preventive Services Task Force: Screening for thyroid dysfunction (March 24, 2015)
- Moqri M, et al. Validation of biomarkers of aging. Nat Med. 2024;30(2):360-372.
