Add a decade or more with complete cardiometabolic optimization
Optimize cardiovascular risk, metabolic health, and healthspan with a complete medical team committed to pursuing your best possible health.
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Cardiovascular Risk
Metabolic Health
Inflammation
Cardiorespiratory Fitness
Optimize everything that matters to healthspan
Many top physicians believe that the 'normal' ranges for things like cholesterol, blood pressure, and inflammation create elevated risk of disease and needlessly shorten lives.
Careful, personalized management of medication and lifestyle interventions to human-optimal benchmarks can drive the best chance of extended healthspan.
Everything you need to maximize your health: full cardiometabolic diagnostics (twice per year), blood pressure cuff, and all care team visits included.
We know the difference between 'normal' vs optimal and go beyond the guidelines to maximize your health.
Transform your heart health in the fastest, most sustainable way with medication plus lifestyle, led by an expert team.
Chat with your own personal team: cardiologist, pharmacist, & longevity coach — available anytime in the app.
Be a co-pilot, not a passenger. Work with a care team that really listens to you and gets your priorities.
Get a personalized, iterative plan based on your body's unique response to medications and lifestyle changes.
"I'd be lost if you took this away from me."
Riva Patient
"This was what I needed."
Current Heart Health Patient
“Wow – this actually works.”
Dr. Richard Zane
How it Works
Test your current cardiovascular risk, respiratory fitness, insulin resistance, and more. Develop a plan and manage immediate risks (e.g. blood pressure).
As you introduce lifestyle changes and test medications, some shorter-term numbers (like blood pressure or VO2max) should show clear trends, and your plan may change. Dosages and medication types will be adjusted, and lifestyle recommendations improved.
By month 3, lifestyle changes should clearly impact certain numbers. If lifestyle alone can achieve optimal numbers, medications may be reduced. Otherwise, a more aggressive approach may be warranted.
At this point, results on all numbers should be observable, across the full cardiometabolic diagnostic panel. Your concierge physician and team will evaluate which tests should be re-run, or if any new ones should be introduced.
Ideally, your numbers are at least a decade ahead of your chronological age, on average. Depending on your specific situation, year 2+ may be more of a maintenance mode, or a continued aggressive game plan. Healthspan lowers over time, and maximizing your longevity is a lifelong process.
Get a complete picture of your cardiometabolic health.
Coronary Artery Calcium
One of the most important heart tests you can get. Calcium deposits can narrow the arteries and drive risk of a heart attack or other issues.
Advanced Lipid Panel
More than the basics. HDL, LDL, triglycerides, VLDL, ILDL, and non-HDL to HDL ratio—plus LDL particle numbers, cholesterol particle sizes, and patterns.
Apolipoprotein B & little (a)
The most predictive cholesterol test there is. People with the lowest apoB have the best chance to avoid atherosclerosis and heart attacks.
B-Type Natriuretic Peptide
A hormone secreted by ventricular cardiomyocytes, an indicator of heart function.
Homocysteine
An amino acid related to heart health and potential dietary factors like B12, B6, or folic acid.
Vitamin D
Deficiency is associated with increased risk of CVD, including hypertension, heart failure, and ischemic heart disease.
VO2max
The JACC found that people in the top 5% of VO2max lived about 5 years longer than those in the bottom 5%.
Blood Pressure
Drives risk of premature heart and brain aging, and one of the easiest risk factors to modify.
Hemoglobin A1c
Evaluates metabolic health and insulin resistance over the previous 3 months.
Fasting Blood Glucose
Assesses metabolic function, insulin resistance, and diabetes risk. Affects longevity and risk of heart attacks.
Comprehensive Metabolic Panel
Measures 14 unique substances in your blood, and evaluates liver/kidney function.
Thyroid Stimulating Hormone
Has direct effects on heart function, blood vessels and cholesterol levels. Affects metabolism and blood pressure.
High-Sensitivity C-Reactive Protein
One of the best indicators of inflammation, which is a causal factor in premature aging and most chronic disease risks.
Neutrophil to Lymphocyte Ratio
An indirect metric of systemic inflammation which has some predictive power on longevity and robustness to illness.
Complete Blood Count
Evaluates overall health and detect a wide range of disorders, including anemia, infection, inflammation and certain cancer risks.
Live Longer, Live Better
Cardiovascular health and metabolism decline with age. The best time to be proactive was yesterday, and the next best time is now. Be aggressive and protect your longevity.
Frequently Asked Questions
- Group chat with your own personal health coach, pharmacist, and doctor anytime you need
- Video appointments with your care team to create and manage your personalized plan
- All lab tests and diagnostics (e.g. calcium scan), twice per year
- A free connected blood pressure cuff and full welcome kit
- Evidence-backed, personalized program designed by doctors and behavioral scientists to make it easy to reach your health goals
Right now, medications are not included due to variance in insurance coverage. Most medications for heart health and metabolism are relatively inexpensive, but some may be costly. Your insurance likely covers medications prescribed by Riva, and if not, we will work with you to create a medication plan that is financially-aligned.
Your blood pressure cuff and welcome kit are delivered to your home for free. Medications are called into your preferred pharmacy, with home delivery as an option arriving in the next few months.
Over 98% of people on the program reached their blood pressure goal, and the average person did so in under 3 weeks. Cholesterol and other blood tests tend to improve a little slower, though a lab test is required to measure these, so the timeframe to assess can vary. Expect a minimum of 3 months to meaningfully change cholesterol or A1c numbers, and a recommendation to measure every 6 months. A coronary artery calcium test need not be redone more often than every 2-3 years. That said, everyone's health is different, so your care team will set the right expectations for you based on your unique health situation and history. No doctor can promise a specific longevity or healthspan benefit for any treatment, but we will provide you the best estimates we can off of the best quality research and population data which are available.
More importantly, you should expect to have a great experience and feel like your care team is really there for you. If you're not happy with doctor, pharmacist, and coach or the results you're getting, ask for a refund and you'll get it. No questions asked.
If you have high blood pressure or cholesterol, getting these to a healthy range can add several years to your life (up to 14 in previous studies). Maintaining a healthy heart can also reduce your risk of heart attack, heart failure, or stroke by 50% or more. Blood pressure has been found to affect cognition and risk of dementia, along with rates of brain aging and DNA methylation. Certain medications are believed to have the potential to extend lifespan or healthspan by multiple years, but these have not been evaluated in long-term human studies. The specific amount you'll benefit on any given metric will vary based on your starting point, overall health situation, and other factors. Your doctor can help you understand what to expect while taking your personal situation into account.
Reducing body fat, improving your diet, mitigating stress, and improving cardiorespiratory fitness will typically improve your heart risk, cognitive function, metabolic health, and longevity as well. Your team will guide you toward the best bang-for-buck lifestyle and medication interventions based on your situation and preferences, and use the best available data to frame the potential benefits you might receive to healthspan, lifespan, and specific health risks.
Insurance is not required. The Riva cardiometabolic optimization and longevity program isn't covered by insurance. If you do have insurance, this can make medications and non-included lab tests (e.g. for specific familial cancer risks) a little cheaper, but sometimes paying out-of-pocket is actually less costly overall. Unfortunately, health insurance is a confusing topic. Your coach or pharmacist can help you figure out how to get the most value based on your situation.
Your care team will typically involve:
- A concierge cardiologist or cardiology-specialized nurse practitioner (similar to a doctor)
- A pharmacist specialized in heart health, cholesterol, and weight loss medications
- A health coach, who will have a background in longevity science, nutrition, fitness, psychology, or similar expertise
You can send a message to your care team anytime, 24/7. Someone will generally respond within 24 hours during the work week.
You'll have a video call with each care team member early in your experience, typically two weeks of starting with Riva. During the program, you should expect a message every week from your coach, often daily in the beginning or during certain periods. You can work out a schedule with your care team, but calls with your coach every 1 or 2 weeks are normal while you're working on your goal. After hitting your initial goals, you will have calls as often as you and your coach align on.
Calls with your concierge doctor, nurse practitioner, or pharmacist are usually only required for when you are starting the program and then every 1 or 2 quarters. If it makes sense to speak more often than that, the team reserves the right to be flexible and provide the time they think is necessary for each individual patient. There are no strict limits or cutoffs to the interaction each patient receives.
Messaging your care team is not appropriate for medical emergencies, and for that scenario, you should always call 911 immediately.
The vast majority of people on the program reach their health goals and report having a great experience with their care team. That said, if you don't, we will refund you 100% of the cost of your Riva subscription. The costs of medications, tests, and certain other services provided are unfortunately not refundable, since they go through other companies.
Don’t put off something that could echo across decades
Act aggressively to cut your risk of heart attack and stroke by 50% or more, protect yourself against cardiorespiratory and cognitive decline, and ensure you have the best last decades that a human can get.