Is Your Cholesterol Test Missing Something? Cardiologists Recommend This Heart Health Test
Is Your Cholesterol Test Missing Something? Cardiologists Recommend This Heart Health Test
When it comes to assessing your heart health, a standard cholesterol test, also known as a lipid panel, is often the first step. However, some leading cardiologists are now recommending an additional test – the Apolipoprotein B (APOb) test – to gain a more accurate understanding of your cardiovascular risk.
Why APOb Matters for Heart Health
The APOb test measures the level of apolipoprotein B in your blood. ApoB is a protein that is attached to "bad" cholesterol particles, such as LDL (low-density lipoprotein), VLDL (very-low-density lipoprotein), and IDL (intermediate-density lipoprotein). Each of these harmful particles has one ApoB protein. Therefore, measuring ApoB can provide a direct count of these particles, which are the primary culprits in plaque buildup in arteries, leading to heart disease and stroke.
Cardiologists and researchers are increasingly finding that the APOb test can offer a more precise assessment of heart disease risk compared to a standard lipid panel alone. This is because the traditional lipid panel primarily measures the amount of cholesterol, while ApoB reflects the number of harmful cholesterol-carrying particles.
Cardiologists Leading the Charge for APOb Testing
Several prominent cardiologists are advocating for wider use of the APOb test, especially for individuals who may not be accurately assessed by standard lipid panels. Here are a few examples of cardiologists who have recently highlighted the importance of APOb testing:
- Dr. Ann Marie Navar, UT Southwestern Medical Center: As the lead author of a study published in JAMA Cardiology in August 2024, Dr. Navar argues that current guidelines may be underestimating heart disease risk by not recommending ApoB testing for everyone. Her research indicates that some individuals with seemingly normal LDL-C levels may have elevated ApoB, signaling a higher risk that might be missed by standard tests. ApoB test may be more accurate measure of heart disease risk: Newsroom - UT Southwestern, Dallas, Texas
- Dr. Salim Virani, The Texas Heart Institute and Aga Khan University: Dr. Virani, in an interview with Healthline, points out that for certain patient groups, such as those with obesity, high triglycerides, or metabolic syndrome, the APOb test can be particularly valuable. In these cases, traditional LDL cholesterol measurements may not fully capture the risk, and ApoB testing can provide clinicians with more actionable information 1 for treatment decisions. Heart Disease: How ApoB Cholesterol Tests Can More Accurately 2 Identify Risks, Treatments
1. med.stanford.edu2. medicaid.utah.gov
- Dr. Deehan, Cardiologist (Mentioned in Healthline): Dr. Deehan emphasizes that cardiovascular risk is more closely linked to ApoB levels than to other common lipid measurements. She advocates for APOb testing as a complement to, rather than a replacement for, traditional cholesterol tests, providing a more comprehensive risk profile. Heart Disease: How ApoB Cholesterol Tests Can More Accurately Identify Risks, Treatments
Guidelines are Evolving to Include APOb
Major cardiovascular organizations are also recognizing the value of APOb testing. The 2021 Canadian Cardiovascular Society guideline, for instance, recommends ApoB measurement as an alternative to LDL-C for screening and treatment targets. Apolipoprotein B in cardiovascular risk assessment - PMC Additionally, guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA) acknowledge the importance of ApoB in specific clinical scenarios. Low prevalence of testing for apolipoprotein B and lipoprotein (a) in the real world - PMC
Benefits of APOb Testing
- Potentially More Accurate Risk Assessment: For some individuals, especially those with metabolic risk factors, APOb may provide a more accurate picture of cardiovascular risk.
- No Fasting Required: Unlike traditional lipid panels, you don‘t need to fast before an APOb test, making it more convenient. Apolipoprotein B (APOB) Test - Cleveland Clinic
- Direct Measurement: APOb is measured directly, whereas LDL-C is often calculated, which can be less accurate in certain situations. Apolipoprotein B in cardiovascular risk assessment - PMC
Should You Get an APOb Test?
If you are concerned about your heart health, especially if you have risk factors like obesity, diabetes, high triglycerides, or a family history of heart disease, talk to your doctor about whether an APOb test is right for you. While a standard lipid panel remains an important screening tool, incorporating APOb testing may provide a more complete and personalized assessment of your cardiovascular risk, allowing for more informed decisions about prevention and treatment.
Consult with your cardiologist or healthcare provider to determine if APOb testing is appropriate for your individual health needs.
