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  • Testing for a type of protein may be a better measure for heart disease risk than cholesterol tests.
  • It’s widely known that LDL cholesterol — aka bad cholesterol — can cause atherosclerosis, or plaque buildup in the arteries.
  • But now new research finds that testing for apolipoprotein B-100 (ApoB) that attaches to LDL cholesterol may better predict whether or not you’re heart healthy.

A blood test for a certain protein may do a better job at detecting heart disease than only measuring cholesterol levels, according to an analysis published in the Journal of the American College of Cardiology.

The test measures levels of apolipoprotein B-100 (ApoB). This protein attaches to disease-promoting cholesterol or LDL cholesterol.

HDL cholesterol or good cholesterol does not carry the protein.

It’s widely known that LDL cholesterol — aka bad cholesterol — can cause atherosclerosis or plaque buildup in the arteries. A common test for LDL cholesterol levels can measure the mass of this “bad” cholesterol in the body, but the protein test will actually get the results for the number of particles.

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.

“This study highlights an important tool that could potentially help us keep patients out of the hospital for cardiovascular events such as heart attacks and strokes while in addition helping to lower the overall incidence of atherosclerotic heart disease,” says Wafi Momin, DO, cardiologist with UTHealth Houston Heart & Vascular and Memorial Hermann.

Using the 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.

Though the frequency of ApOb testing increased during the study period, the researchers found that the test is still underutilized.

The team also found that 46% of the patients had elevated ApoB levels, even when their LDL cholesterol levels were considered to be in the healthy range.

Dr. Joyce Oen-Hsiao, Yale Medicine cardiologist, says that high levels of ApoB indicates there are a lot of bad cholesterol particles circulating in your 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.

A more effective way to gauge their risk is to conduct an ApoB test, according to the researchers.

“By measuring how much ApoB there is, we get a better picture of how much bad cholesterol is circulating — not just the LDL cholesterol,” Oen-Hsiao said.

If ApoB levels are high, patients may benefit from treatment to lower their cardiovascular risk.

“Measurement of ApoB can actually help to identify patients at risk earlier and treating them accordingly with lifestyle modifications and lipid-lowering therapy could potentially decrease their incidence of cardiovascular disease,” says Momin.

People with a family history of heart disease, those who’ve already had a stroke or heart attack, and patients with high cholesterol levels should get an ApoB test, says Dr. Rigved Tadwalkar, a board-certified cardiologist at Providence Saint John’s Health Center in Santa Monica, CA.

“Additionally, people who are receiving treatments for hyperlipidemia can benefit from this test as it can assist with more effective management of their condition,” Tadwalker said.

ApoB levels can also be drawn in healthy patients who want to know their full cardiovascular risk, Oen-Hsiao noted.

The ApoB test is a simple blood test that is ordered in addition to the basic cholesterol panel.

Not everyone will need to have an ApoB test done, so consult with your doctor if you’re interested in evaluating your risk for heart disease.

Testing for ApoB is on the rise, says Tadwalker, as there’s now greater awareness of its usefulness.

Cardiologists hope this test will become more widely used to identify risk factors and help prevent heart disease.

“This could potentially be helpful in bending the curve of cardiovascular disease around the world,” Momin said.

A simple blood test may do a better job at detecting heart disease than only measuring cholesterol levels, according to a new analysis. The test measures levels of apolipoprotein B-100 (ApoB) — a protein that transports bad cholesterol throughout the body. ApoB testing could help more individuals, especially those with normal cholesterol levels, gauge their risk of heart disease.