Cholesterol, a fat-like substance produced by the liver, is an important body substance that helps make cells and performs other functions involving vitamins, and hormones. Cholesterol is carried through the blood on proteins, called ‘lipoproteins’.

There are two types of lipoproteins that carry cholesterol throughout the body: Low-density lipoprotein (LDL) cholesterol, sometimes called ‘bad’ cholesterol, which makes up most of your body’s cholesterol; and High-density lipoprotein (HDL) cholesterol, sometimes called ‘good’ cholesterol. Too much LDL cholesterol can lead to it building up on the walls of your blood vessels. This buildup is called ‘plaque’, and it can cause health problems, such as heart disease and stroke.

On the other hand, HDL cholesterol absorbs excess cholesterol in the blood and carries it back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke. A simple blood test can determine your levels of LDL and HDL cholesterol. The results of cholesterol tests can determine whether you need to start taking medications or adopt certain lifestyle changes to bring your cholesterol levels into a healthy range.

While standard blood tests can reveal the levels of LDL and HDL in the blood, it cannot predict the condition of the heart, as it only measures the mass of the two cholesterols in the blood. New research now finds that testing for apolipoprotein B-100 (ApoB) that attaches to LDL cholesterol may be a better test to detect whether or not your heart is healthy, as it detects the number of particles of LDL cholesterol. HDL cholesterol or good cholesterol does not carry the ApoB protein.

According to the findings, the test can be used to identify more patients at risk for heart disease, especially those whose cholesterol levels appear normal. The new test could prove an important tool in providing early warning that potentially helps keep patients out of the hospital for cardiovascular diseases such as heart attacks and strokes.

For their study the researchers used health data of 705 individuals collected between 2010 and 2022, the researchers evaluated how many of the patients were tested for ApoB and LDL cholesterol levels. The team found that 46 percent of the patients had elevated ApoB levels, even when their LDL cholesterol levels were considered to be in the healthy range.

The high levels of ApoB indicated that there were a lot of bad cholesterol particles circulating in the patient’s body, which increases the risk of heart disease, stroke, and heart attack. The findings suggest that some people with healthy cholesterol levels may still be at risk for heart disease.

Though the frequency of ApoB testing among people increased during the study period, the researchers found that the test is still underutilized. They added that more people should gauge their risk of heart disease by conducting an ApoB test, as it provides a better picture of how much bad cholesterol is circulating — not just the mass of LDL cholesterol.

People who should look to take an ApoB test are those who have a family history of heart disease, patients with high cholesterol levels and those who have already had a stroke or heart attack. Doctors say that measurement of ApoB can actually help to identify patients at risk earlier and recommend lifestyle modifications and lipid-lowering therapies that could potentially decrease their incidence of cardiovascular disease. Cardiologists hope this test will soon become more widely used to identify risk factors and help prevent heart disease.


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