For nearly 60 years, doctors have used blood cholesterol levels to find out who is at high risk of heart disease.
But a new study from Chalmers University of Technology in Sweden and Harvard University in the U.S. shows that a different kind of blood test might be even better.
This test looks at two markers in the blood, and it may give a clearer picture of who could develop heart problems in the future. The results could help save lives.
Heart disease is the number one cause of death in the world. The World Health Organization (WHO) says many heart problems can be prevented by healthy lifestyle choices like eating well, not smoking, and being active. Still, it is important to catch risks early so doctors can step in before serious problems happen.
Cholesterol is a fat-like substance in our blood. We need it to build cells and make certain vitamins and hormones. But too much cholesterol can stick to the walls of blood vessels and form clumps called plaques. These plaques can block blood flow and cause heart attacks or strokes. Cholesterol travels through the blood in small particles called lipoproteins.
There are four main types of lipoproteins, but three of them carry a special protein called apolipoprotein B (apoB). These are the “bad cholesterol” particles because they can build up in blood vessels. The fourth type helps remove extra cholesterol and is often called “good cholesterol.”
Right now, most doctors test for the amount of cholesterol in the blood. But cholesterol by itself can’t move through the blood without a lipoprotein. That’s why scientists are now looking more closely at these carriers—especially those with apoB—as better ways to measure heart disease risk.
The new study looked at data from more than 200,000 people in the UK who had no history of heart disease. The researchers measured the number and size of different lipoproteins in each person’s blood. They followed the participants for up to 15 years to see who had heart attacks. The team then checked the results again in a second group of people in Sweden.
They found that the total number of “bad cholesterol” particles—marked by apoB—was the best way to tell who might get heart disease. People with more of these particles were more likely to have a heart attack later on. This test was more accurate than traditional cholesterol tests, which can miss high-risk cases in about 1 in 12 people.
Another important finding was about lipoprotein(a), a special type of “bad cholesterol” that people are born with. Although it makes up only a small amount of total lipoproteins in most people, some have very high levels.
These people face a much greater risk of heart disease. The researchers suggest that doctors should test for both apoB and lipoprotein(a) to get the most accurate results.
Dr. Jakub Morze, one of the lead researchers, said that switching to apoB testing could make a big difference. Standard cholesterol tests are still useful, but adding apoB could catch more high-risk cases early. Dr. Clemens Wittenbecher added that the test is simple, low-cost, and already available. He believes it could replace the old cholesterol test in the future.
Overall, this study gives strong evidence that measuring lipoprotein carriers—especially those with apoB—can give doctors a better tool to predict heart disease. It also shows the importance of looking at inherited factors like lipoprotein(a). These insights could help people get the right treatment earlier and reduce the number of heart attacks and strokes.
If you care about heart disease, please read studies that herbal supplements could harm your heart rhythm, and how eating eggs can help reduce heart disease risk.
For more health information, please see recent studies that apple juice could benefit your heart health, and results showing yogurt may help lower the death risks in heart disease.
The study is published in the European Heart Journal.
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