Cholesterol is a waxy substance that’s naturally made by the liver. You need a certain level of cholesterol so your body can make vitamin D and hormones. However, having high cholesterol, or hypercholesterolemia, is a major risk factor for heart disease, the leading cause of death in the United States.

A simple lipid panel blood test can measure your cholesterol and give you an idea of your cardiac risk. Occasionally, a vertical auto profile (VAP) cholesterol test might be recommended.

This type of advanced cholesterol testing measures blood cholesterol components in greater detail than a standard lipid panel.

This article will take a closer look at the VAP cholesterol test, how it compares to standard screenings, and who stands to benefit the most from this type of test.

A VAP test is a type of advanced cholesterol screening. It’s not part of a standard lipid panel. This means your doctor will need to specifically order this test.

The VAP test can help determine your risk of heart disease and metabolic syndrome, a risk factor for heart disease. It’s more specific than a standard lipid profile.

For context, a standard lipid profile measures the following components:

In general, a high level of LDL cholesterol is associated with an increased risk of heart disease. However, it’s still possible to develop heart disease if you have healthy LDL cholesterol levels. This is where a VAP test might be useful.

A VAP test measures additional components of blood cholesterol compared to a standard lipid profile. Thus, it may help identify heart disease risk in people who have “normal” lipid profiles.

A VAP test is done like a typical blood cholesterol test. It can be done at a doctor’s office or a lab testing center. You don’t need to fast beforehand.

During the test, a health provider draws your blood. Your blood sample is sent to a laboratory, where it’s placed in an ultracentrifuge. This is a machine that spins your blood sample at very high speeds and separates cholesterol components based on their density.

The separated components are then measured, which will indicate the concentration of each one in your blood.

The VAP test measures the same components as a standard screening, plus several other components. This includes the following types of cholesterol:

  • triglycerides
  • HDL cholesterol
  • LDL cholesterol
  • total cholesterol
  • very-low-density lipoprotein (VLDL)
  • lipoprotein(a) (Lp(a))
  • intermediate-density lipoprotein (IDL) cholesterol
  • HDL subclasses (HDL2 and HDL3)
  • LDL subclasses (LDL1, LDL2, LDL3, LDL4)
  • VLDL subclasses (VLDL1, VLDL2, VLDL3)
  • LDL maximum time (indicates LDL size)

The first four components are also measured in a standard lipid profile. The other components are only measured in a VAP cholesterol test.

Although the VAP test measures more cholesterol components than a standard screening, its accuracy is uncertain.

The main concern involves Lp(a) concentration. A 2016 study found that the test may inaccurately measure Lp(a) because its density overlaps with HDL cholesterol.

This can make it difficult to separate the levels for individual components. As a result, the Lp(a) concentration obtained from a VAP test might be inaccurate.

Also, according to a 2020 study, high triglyceride samples might interfere with the separation of lipoproteins. This could yield inaccurate results.

Still, a 2017 review notes that the VAP test “resolves the inaccuracy” of detecting heart disease risk in standard cholesterol screenings.

If you’re interested in the VAP cholesterol test, talk to your doctor. They can determine if the screening is right for you.

The VAP test may help determine your risk of heart disease and metabolic syndrome. It can be used in addition to standard lipid panels, which may not fully explain heart disease risk.

Similarly, it can be used with fasting glucose or insulin tests, which also might not detect the risk of metabolic syndrome.

The VAP cholesterol test is most beneficial for people who have a known high risk of heart disease. This includes those who have:

Compared to basic cholesterol screenings, the results of a VAP test may alter your medical treatment. That’s because your doctor can use the extra data to optimize your treatment plan.

A VAP cholesterol test is a type of advanced cholesterol screening. It measures triglycerides, HDL cholesterol, LDL cholesterol, and total cholesterol, just like a standard lipid profile.

However, the VAP test also measures other cholesterol components. This includes VLDL cholesterol, lipoprotein(a), IDL cholesterol, LDL maximum time, and subclasses of HDL, LDL, and VLDL. The additional measurements can be more beneficial for identifying your heart disease risk, especially if you have existing risk factors.

If you’re interested in the VAP cholesterol test, talk with your doctor. They might recommend the test if you have certain risk factors for heart disease, such as diabetes and insulin resistance.