A More Accurate Test to Assess Cardiovascular Risk?

Chances are if you’re over the age of 30, you have received a lipid panel from your doctor. This is a test that measures things like the concentration of your “good” cholesterol/HDL , “bad” cholesterol/LDL, and triglycerides. This test has traditionally been used to asses your level of cardiovascular risk, since elevated LDL is linked with with the entrance and deposition of cholesterol into arteries, AKA atherosclerosis, AKA clogging up your arteries … for which we do have surgical procedures that essentially roto-rooter your vasculature and then place a stent. But it’s best to not need that, right? And to not cause atherosclerotic damage to vasculature throughout the body, and related adverse outcomes like heart disease and stroke.

While measuring LDL on a routine basis is importan to inform if you need to make dietary or drug changes to improve your numbers, there is a test that in recent years has proved to be a more accurate test to assess cardiovascular risk: apolipoprotein B, or, apoB for short.

ApoB is the primary protein of a LDL particle. ApoB is essential for the formation of the LDL particle. Though all LDL particles contain ApoB, the concentration of cholesterol in LDL particles vary. Because concentration varies, measuring the unique number of atherogenic ApoB particles is advantageous to more accurately measure cardiovascular risk. One recent strong study explored the relationship of ApoB on lifespan and major diseases, and found that higher circulating levels of ApoB significantly increased disease risk and therefore reduced expected lifespan, especially for heart disease, stroke and type 2 diabetes. Another key finding of this study is that the number of circulating apoB particles, rather than their concentration of cholesterol, was an important factor in heart disease and stroke risk. Other literature supports that the number of ApoB particles matters more than the concentration of cholesterol within a particle, because it is the whole particle that deposits into arterial wall.

So is getting your LDL measured still relevant? Yes! Cholesterol content of a particle still matters in the process of atherosclerosis, but within the context of the ApoB particle becoming trapped. And, LDL is highly associated with ApoB. Getting BOTH tested can just give you a more comprehensive and accurate view of your cardiovascular health. Check out the image below to understand more about how variability of the different measures impacts risk.

Now at this point you may be wondering how to get your ApoB measured? Just ask your provider! If you are in Southeast Michigan or the Metro Detroit area and need help getting testing, you can contact me to come get your test at Healthspan in Grosse Pointe Farms! Our phlebotomist is in-office the fourth Monday of every month.

And if your ApoB comes back high, what’s the best way to lower it via nutrition? I’ll save writing that article for later, because it deserves a post by itself. But if you need help managing your blood lipids and cardiovascular health, contact me for nutrition counseling or make an appointment with Dr. Gomez at Healthspan, our brilliant cardiologist.