Concierge · Physician-Led · Precision Cardiovascular Prevention
An executive-tier cardiovascular prevention program led by a board-certified clinical lipidologist — combining advanced imaging, AI plaque analysis, and modern lipid therapy to identify and reverse risk decades before symptoms appear.
CAC Scoring · Cleerly AI · HeartFlow FFR-CT · CIMT · VO₂ Max · ApoB · Lp(a)
Advanced Risk Assessment
Cardiovascular disease is still the leading cause of death — and it is also one of the most preventable. Our concierge program builds a personalized risk picture from advanced imaging, advanced lipid biomarkers, genetic and family history, cardiorespiratory fitness, and metabolic profiling.
From that picture we design an individualized prevention plan — not a generic risk calculator, not a one-size-fits-all statin recommendation. Every decision is anchored to your biology, your family history, and the trajectory we can actually measure and change over time.
The Technologies
We coordinate this testing through trusted imaging and laboratory partners, then interpret the results in the context of your full clinical picture.
01
A low-radiation CT scan that detects calcified plaque inside the coronary arteries.
CAC scoring identifies hidden coronary artery disease years — sometimes decades — before symptoms appear. The Agatston score refines cardiovascular risk far beyond standard cholesterol panels and helps tailor a precise, personalized prevention strategy.
02
Artificial-intelligence interpretation of coronary CT angiography.
Cleerly AI moves beyond a single calcium number to quantify total plaque burden, plaque composition (calcified, non-calcified, low-attenuation), and individualized cardiovascular risk. It turns a static image into a longitudinal map we can act on.
03
Computational fluid-dynamic modeling of coronary blood flow from a CT scan.
HeartFlow tells us whether a given coronary lesion is actually limiting blood flow to the heart muscle. It improves clinical decision-making and helps avoid unnecessary invasive catheterizations — a hallmark of modern, precision cardiology.
04
Non-invasive ultrasound of the carotid artery wall.
CIMT measures the earliest structural changes of vascular aging and atherosclerosis — often before any traditional risk factor turns abnormal. It is also one of the most powerful tools for monitoring how well prevention is working over time.
05
Cardiorespiratory fitness — one of the strongest predictors of longevity.
VO₂ max correlates more powerfully with all-cause mortality than smoking, hypertension, or diabetes. We use it to anchor your exercise prescription and to track cardiovascular fitness as an objective outcome of your program.
06
ApoB, Lp(a), particle counts, oxidized LDL, and inflammatory markers.
Standard cholesterol panels miss a meaningful fraction of cardiovascular risk. Advanced lipid testing quantifies the particles that actually drive atherosclerosis — ApoB and Lp(a) chief among them — and exposes residual risk that conventional labs cannot see.
CAC, Cleerly AI, HeartFlow FFR-CT, and CIMT studies are performed by qualified third-party imaging providers. VO₂ max and advanced lipid testing are coordinated through accredited laboratories and exercise-physiology partners. Perpetua provides the physician oversight, integrated interpretation, and ongoing treatment plan.
Understanding Plaque Composition
Modern AI-assisted coronary CT analysis (Cleerly) characterizes coronary plaque by composition — not just by how much calcium is present. This distinction profoundly changes how we estimate risk and how aggressively we treat.
Highest Risk
Lipid-rich · vulnerable · highest-risk
Soft, lipid-rich plaque with a thin fibrous cap. Cleerly AI flags this as the most vulnerable composition — the type most associated with plaque rupture, acute coronary syndromes, and heart attacks. Identifying it early lets us intervene aggressively before an event occurs.
Intermediate Risk
Fibrous · intermediate-risk
Fibrous, non-calcified plaque sits between vulnerable lipid cores and stable calcified disease. It signals active atherosclerosis that is progressing but has not yet calcified. The goal of treatment is to stabilize this plaque — and ideally see it regress over time.
Most Stable
Stable · long-standing disease
Dense calcium deposits within the vessel wall. Calcified plaque is the most stable composition and the easiest to detect on imaging, but it is also evidence of long-standing atherosclerosis — a clear signal that comprehensive prevention is warranted.
Illustrations are educational renderings of the three primary plaque compositions characterized by AI-assisted coronary CT (Cleerly). They are not actual patient images and are not affiliated with Cleerly, Inc. Patient imaging is performed by accredited third-party providers and interpreted as part of your individualized prevention plan.
Advanced Lipid Management
Dr. Juan Chavez holds advanced training in lipidology through the American Board of Clinical Lipidology (ABCL) and specializes in evaluating and treating the full spectrum of dyslipidemia and residual cardiovascular risk.
Treatment is highly individualized — combining lifestyle optimization, nutrition, and exercise with evidence-based pharmacotherapy when clinically appropriate.
Conditions We Manage
Evidence-Based Therapies
Therapy selection, titration, and monitoring are physician-led and reassessed for each patient over time.
Comprehensive Prevention
Cardiovascular prevention only works when every meaningful lever is addressed in concert. Our concierge model is designed to do exactly that.
Next Step
Apply for membership and meet with our physician team to build your personalized cardiovascular prevention plan.
Perpetua Longevity is a virtual physician-led practice. Imaging and laboratory studies are performed by accredited third-party partners. Educational content on this page is not a substitute for individualized medical advice.
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