Cardio Longevity: The key to a long, healthy life lies in the heart and blood vessels - we cover the entire Longevity range

Cardio Longevity is the approach of modern preventive medicine that focuses specifically on maintaining the health of the cardiovascular system in order to maximize the healthy lifespan (Healthspan). While longevity has many facets, the scientific evidence is clear: by far the greatest lever for more years of healthy life is the prevention of cardiovascular disease. As your cardiologist and specialist in preventive medicine, Dr. Raphael Bruno will guide you through the process with an approach based on scientific evidence. Cardio Longevity-strategy.

Why cardio longevity is the basis of every longevity strategy

Cardiovascular diseases are still the most common cause of death and loss of quality of life in old age in the western world. The ageing process of our body is inextricably linked to the health of our blood vessels. A healthy cardiovascular system supplies every single cell in our body - from the brain to the muscles to the kidneys - with oxygen and nutrients.¹ If the function of this system deteriorates, the entire organism suffers. An effective Cardio Longevity-Therefore, a healthy lifestyle strategy is not only a matter of the heart, but the basis for the health of the whole body, including the prevention of dementia and kidney disease.

The main enemies of cardio longevity: arteriosclerosis and endothelial dysfunction

In order to Cardio Longevity we need to understand and tackle the two key processes that age our blood vessels.

1. arteriosclerosis: the silent process of plaque formation

Arteriosclerosis („vascular calcification“) is the main driver of heart attacks and strokes. The process begins when „bad“ blood lipid particles (especially LDL particles) penetrate the vessel wall and trigger a chronic inflammatory reaction. Over years and decades, plaques form from this, narrowing the vessels.² The modern Cardio Longevity aims to stop this process as early and as aggressively as possible.

2. endothelial dysfunction: the dysfunction of the vascular endothelium

Long before plaque becomes visible, the disease often begins with a functional disorder of the endothelium, the wafer-thin layer of cells that lines the inside of our arteries. A healthy endothelium ensures that the vessels remain elastic and can widen when necessary. Risk factors such as high blood pressure, smoking or high blood sugar levels damage this layer and make it „leaky“ and rigid - the first step towards arteriosclerosis.³

Measuring cardio longevity: The most important biomarkers and examinations

A modern Cardio Longevity-strategy is not based on guesswork, but on measurement. We use advanced diagnostics to precisely determine your individual cardiovascular risk and your „biological vascular age“.

Biomarker / measured value	What it measures	Why it is crucial for cardio longevity
Apolipoprotein B (ApoB)	The number of potentially vascular-damaging blood lipid particles (all „non-HDL“ particles).	Is now considered a more precise marker for the risk of arteriosclerosis than pure LDL cholesterol. The lower, the better.
Lipoprotein(a) [Lp(a)]	A special, highly genetically determined blood lipid particle.	A high Lp(a) value is an independent and often underestimated main risk factor. Knowing it is essential for an accurate risk assessment.
hs-CRP (highly sensitive C-reactive protein)	The extent of chronic, low-threshold inflammation in the body („silent inflammation“).	Chronic inflammation is a „fire accelerator“ for arteriosclerosis. A low value is the goal.
VO₂max (maximum oxygen uptake)	The body's maximum ability to absorb and utilize oxygen.	One of the strongest predictors of overall life expectancy. A high value is a sign of an excellent cardiovascular system.

These and other parameters, such as blood pressure and long-term blood glucose (HbA1c), together provide your personal Cardio Longevity-profile.

Strategies for maximum cardio longevity: nutrition, exercise, medicine

Based on your individual risk analysis, we develop a multi-stage strategy to optimally protect your cardiovascular system.

Aggressive management of risk factors: This is the core of the medical Cardio Longevity.
- LDL cholesterol / ApoB: The goal is not „normal“, but „optimal“. For many people, this means reducing their values to a very low level through diet and, if necessary, modern medication.
- Blood pressure: Strict control of blood pressure to levels around 120/80 mmHg or below is crucial to protect the endothelium.
- Blood sugar: Avoiding blood sugar peaks and maintaining high insulin sensitivity are key.
Anti-inflammatory lifestyle: A diet rich in polyphenols (in colorful vegetables, berries, olive oil), regular exercise and sufficient sleep have an anti-inflammatory effect.
Targeted training: One of the main reasons for the increase in VO₂max and the maintenance of muscle mass.

Cardio Longevity and the role of sports medicine: VO₂max as a vitality marker

Sports medicine plays an important role in modern Cardio Longevity plays a key role. The most important parameter for a long, healthy life that can be influenced by training is VO₂max. It is a measure of the performance of your „cardio machine“ - in other words, how well your heart, lungs and blood vessels work together. Studies show that people with a high VO₂max have a significantly lower risk of cardiovascular disease, cancer and a lower overall mortality rate.⁴ As a sports cardiologist, Dr. Raphael Bruno can use performance diagnostics (spiroergometry) to determine your exact VO₂max and create a highly efficient training program to specifically increase this crucial vitality marker.

Frequently asked questions about Cardio Longevity

Here you will find answers to frequently asked questions about this modern preventive approach.

What is the difference between LDL cholesterol and apolipoprotein B (ApoB)?

LDL cholesterol measures the amount of cholesterol within of the LDL particles. ApoB measures the Quantity of these particles.⁵ Since each potentially harmful particle contains exactly one apoB molecule, measuring the number of particles (apoB) is now considered to be a more direct and precise indicator of the risk of arteriosclerosis.⁶

My blood pressure is only „slightly“ elevated. Is that relevant for longevity?

Yes, from the point of view of the Cardio Longevity there is no such thing as harmless high blood pressure. Every mmHg above the optimal range (approx. 120/80) increases the lifelong strain on the blood vessels. The aim is therefore not only to avoid manifest hypertension, but to maintain an optimal blood pressure over the entire lifespan.

Is it possible to measure and influence „vascular stiffness“?

Yes, with increasing age, the arteries become stiffer, which causes blood pressure to rise. This arterial stiffness can be measured using special devices (e.g. pulse wave analysis) and is a marker for biological vascular age.⁷ Lifestyle factors such as regular exercise and a healthy diet have been shown to help keep blood vessels elastic for longer.

What role do genetics play in cardio longevity?

Genetics determines a certain basic risk, especially via factors such as Lp(a). However, it is not your destiny. It is estimated that 80% of cardiovascular risk is determined by lifestyle and treatable risk factors. A good Cardio Longevity-strategy can often more than compensate for a poor genetic starting position.

Is cardio longevity the same as „anti-ageing“?

No. The term „anti-ageing“ is often unspecific and associated with unproven promises. Cardio Longevity is a scientifically sound medical approach based on the evidence-based treatment of proven risk factors for the most common cause of death, cardiovascular disease.

Isn't it enough to simply live a healthy life?

A healthy lifestyle is the most important foundation.⁸ However, in order to maximize Cardio Longevity it is crucial to know whether your lifestyle is having the desired effect on your biomarkers. Only by measuring can we determine whether your ApoB or blood pressure are really in the optimal range or whether additional medication is necessary to provide you with the best possible protection.

Which diet is best for cardio longevity?

The data clearly supports a plant-based, Mediterranean diet. It is rich in nutrients that have an anti-inflammatory effect, protect the endothelium and have a positive influence on blood lipid levels. A highly processed, sugar- and meat-heavy diet, on the other hand, promotes inflammation and arteriosclerosis.

Is aspirin (ASA) useful for prevention?

The blanket use of ASA for primary prevention is no longer recommended today, as the risk of bleeding often outweighs the potential benefit. The decision for or against ASA is a highly individualized consideration that should be made by an experienced cardiologist as part of a comprehensive Cardio Longevity-advice must be given.

Which medications are the most important for cardio longevity?

When a healthy lifestyle is not enough, drugs to aggressively lower LDL cholesterol/ApoB (such as statins) and optimize blood pressure control are by far the best-studied and most effective drug interventions to extend healthy lifespan.

Is this type of medicine only for the future?

No. The principles of Cardio Longevity can and should already be used today. The underlying treatment strategies - i.e. the consistent lowering of blood pressure and cholesterol - are based on decades of solid research and the current guidelines of the cardiology societies. What is new is the proactive application of these principles in healthy people, aimed at achieving optimal values.

Your roadmap for maximum cardiovascular health

Cardio Longevity is not a passive process, but an active process that you can shape. It is about using the knowledge of modern cardiology not only to live longer, but above all to live longer in good health. If you are ready to invest in your cardiovascular future, make an appointment. We will work with you to create your personalized roadmap.