Cardiovascular prevention is also particularly successful in old people in terms of preventing major cardiovascular events. The concept of prevention of geriatric diseases can, however, be expanded taking the insights of geroscience into consideration, so that slowing the ageing process per se can be set as a new goal: ageing is the pertinent basis of nearly all chronic diseases in adulthood, a line of argument for which the cardiovascular system can serve as a prototype. Consequently, treating ageing can help prevent the typical chronic diseases in old people, i.e. multimorbidity and frailty. According to the current guidelines of the European Society of Cardiology (ESC, Eur Heart J 42:3227-3337, 2021) and the German Society for Cardiology (DGK, https://leitlinien.dgk.org/files/03_pocket_leitlinien_praevention_aktualisiert.pdf ) cardiovascular prevention incorporates age-stratified and individually adapted measures and treatment targets in the domains lifestyle (physical activity, body weight, nutrition), psychosocial factors, cardiovascular risk factors (smoking, blood lipids, blood pressure, diabetes), antithrombotic treatment and disease-specific interventions. From a biogerontological perspective, in the midterm these measures could be supplemented by measures and medicinal treatment strategies to slow the biological ageing process, e.g. with senolytics and metformin. Initial clinical studies using senolytics have already been reported.