A significant component of the ability to survive to exceptional old age may be familial. This study assessed the prevalence of age-related diseases in the offspring of centenarians. The health histories of centenarian offspring (n=177) and controls (n=166) were assessed from 1997-2000 using a cross-sectional study design. The offspring of 192 centenarian subjects enrolled in the nationwide New England Centenarian Study were recruited and enrolled. Controls consisted of offspring whose parents were born in the same years as the centenarians but at least 1 of whom died at an average life expectancy. Prevalence of age-related diseases including heart disease, hypertension, diabetes, cancer, osteoporosis, stroke, dementia, cataracts, glaucoma, macular degeneration, depression, Parkinson's disease, thyroid disease, and chronic obstructive pulmonary disease were compared between the two groups. Centenarian offspring had a 56% reduced relative prevalence of heart disease (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.24, 0.80), a 66% reduced relative prevalence of hypertension (OR 0.34, 95% CI 0.21, 0.55), and 59% reduced relative prevalence of diabetes (OR 0.41, 95% CI 0.15, 1.12) after multivariate adjusted analyses. The offspring of centenarians demonstrate a markedly reduced prevalence of diseases associated with aging, in particular for cardiovascular disease and cardiovascular risk factors. Along with their parents, the centenarian offspring, who are in their 70s and 80s, may prove to be a valuable cohort to study genetic and environmental factors conducive to the ability to live to very old age in good health.