20-05-2025
This Is the Actual Best Way to Measure Risk of Heart Disease—And No, It's Not Cholesterol
Measuring cholesterol levels has always been the gold standard for figuring out who is at highest risk for heart disease. Until now. Researchers have discovered a brand-new way of predicting a person's risk of heart disease. Their findings claim to be more accurate and easier than the current cholesterol test. 🩺SIGN UP for tips to stay healthy & fit with the top moves, clean eats, health trends & more delivered right to your inbox twice a week💊Heart disease is the leading cause of death in America. Yet, most cases are preventable if people take better care of themselves. With one person dying of heart disease every 33 seconds, a better test for early detection could give people more time to change their lives around. Related:
A European Heart Journalstudy suggests that measuring two lipoproteins via a simple blood test is a more accurate predictor of heart disease than cholesterol levels. Cholesterol is often measured for heart disease risk because too much of it can harden and form plaques in the walls of blood vessels. When a plaque ruptures, it can create a blood clot that blocks blood flow, leading to a heart attack or stroke. A cholesterol test is often used to understand how much "bad" cholesterol is present enough to cause serious harm. However, cholesterol cannot harm the heart if not carried there with round-shaped transporters called lipoproteins. Depending on the type of lipoprotein, it can carry either "bad" or "good cholesterol" through the blood.'It was previously unclear if two patients with the same total level of 'bad cholesterol,' but who differ in their carrier characteristics (lipoprotein type, size, lipid content), have the same risk of heart disease. So, this study aimed to determine the importance of these different parameters,' says , a postdoctoral fellow in precision cardiovascular medicine at Chalmers University of Technology in Sweden and lead study author. The authors set their sights on three classes of lipoproteins that carry a special protein called apolipoprotein B (apoB). These carry the "bad cholesterol" to clog up arteries. A fourth lipoprotein class eliminates excess cholesterol in the blood and transports it back to the liver. Related:
The study authors examined blood samples from 200,000 people in the United Kingdom who had no history of heart disease. They were specifically looking for the number and size of cholesterol-carrying lipoproteins in the bloodstream. "Bad" cholesterol carriers were defined as lipoproteins carrying the apoB protein. A 15-year follow-up showed that people with a high number of apoB lipoproteins were the ones more likely to experience a heart attack.'We found that apoB is the best marker when testing for risk of heart disease. Since apoB indicates the total number of 'bad' cholesterol particles, measuring it offers a more accurate test than standard cholesterol measures," explains Dr. Morze."The recent publication confirms what we as lipidologists have already believed for years," says , a co-director of the Center for Advanced Lipid Management at the Stony Brook Heart Institute in New York, and who was not involved in the study. "Measurement of the total number of apolipoprotein B (apoB) particles is a better prognostic marker for cardiovascular risk compared to low-density lipoprotein-cholesterol (LDL-C) alone."The number of lipoproteins carrying the apoB protein was most important in estimating a person's risk of future heart disease. Additionally, the authors discovered lipoprotein(a), which is also linked to heart disease. It represents less than 1% of all lipoproteins carrying "bad" cholesterol, but their levels vary by to Dr. Rahman, previous guidelines considered an elevated apoB above 130mg/dL a factor for heart disease. "With the findings of this article, it should be measured more often and may now be the measurement we need to focus on targeting instead of just LDL-C alone."
Curious about how to get your lipoprotein measurements? Ask your primary care doctor—they should be able to easily order it for you, or at least point you in the right Next:Heart Disease Facts. Centers for Disease Control and Prevention.
ApoB-containing lipoproteins: count, type, size, and risk of coronary artery disease. European Heart Journal.
Dr. Jakub Morze is a postdoctoral fellow in precision cardiovascular medicine at Chalmers University of Technology in Sweden.
Tahmid Rahman, MD, is a co-director of the Center for Advanced Lipid Management at the Stony Brook Heart Institute in New York.
