For nearly 60 years, doctors have measured blood cholesterol to identify who may be at risk of heart disease.
But a large new study from researchers at Chalmers University of Technology in Sweden and Harvard University in the U.S. suggests there may be a better way.
The study found that two specific markers in the blood — apoB and lipoprotein(a) — can give a clearer picture of a person’s risk for heart disease than standard cholesterol tests.
Heart disease is the number one cause of death in the world. Many cases could be prevented by healthy lifestyle choices, but early detection is also key. That’s why scientists are working to improve how we measure heart disease risk.
In this study, researchers looked at data from over 200,000 people in the UK who had no previous heart disease. They examined their blood for different types and sizes of particles called lipoproteins, which carry cholesterol through the bloodstream.
Cholesterol needs these carriers to move through the blood. Some lipoproteins, known as “bad cholesterol” carriers, can lead to harmful buildup in arteries. Others, called “good cholesterol,” help remove cholesterol from the body.
The researchers focused on apolipoprotein B (apoB), a protein found on all “bad cholesterol” particles. They discovered that the number of apoB particles — not their size or type — was the best predictor of future heart attacks.
People with more apoB particles were more likely to develop heart disease. In fact, measuring apoB was more accurate than standard cholesterol tests in identifying who was truly at risk.
Standard cholesterol tests generally work well, but the study showed that in about 1 out of every 12 people, these tests may underestimate the risk.
Since up to 40% of heart attacks are fatal the first time they happen, missing even a small number of high-risk individuals is significant. Testing for apoB could help catch these cases and potentially save lives.
The researchers also highlighted another important marker: lipoprotein(a), or Lp(a). Although it makes up less than 1% of all “bad cholesterol” in most people, very high levels of Lp(a) can dramatically increase heart disease risk.
Unlike other cholesterol levels, Lp(a) is mostly determined by genetics. That means some people may have high levels without knowing it — and they won’t lower it just by eating healthier or exercising more.
The researchers suggest that testing both apoB and Lp(a) should become part of routine health checks. These tests are already available and are affordable. Switching to this new method could improve heart disease prevention and lead to better outcomes for many patients.
In conclusion, while traditional cholesterol testing is still useful, newer methods that measure apoB and Lp(a) may give doctors a clearer and more accurate understanding of a patient’s risk. This could lead to earlier and more effective treatment — and ultimately, fewer people suffering from heart attacks or strokes.
If you care about heart health, please read studies about top foods to love for a stronger heart, and why oranges may help fight obesity, diabetes, and heart disease.
For more health information, please see recent studies about simple guide to a 7-day diabetes meal plan, and why you should add black beans to your plate.
The study is published in the European Heart Journal.
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