Why counting bad cholesterol trucks is better than weighing their cargo
Physiological Bases for the Superiority of Apolipoprotein B Over Low‐Density Lipoprotein Cholesterol and Non–High‐Density Lipoprotein Cholesterol as a Marker of Cardiovascular Risk
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Imagine each bad cholesterol particle as a truck carrying fat. ApoB counts the number of trucks, while LDL-C weighs the cargo. Some trucks carry more, some less. What matters most is how many trucks enter the artery wall, not how heavy their load is. So counting trucks (apoB) is better than weighing cargo (LDL-C).
Surprising Findings
LDL-C can be normal while apoB is high — meaning high heart disease risk despite 'good' cholesterol numbers.
Most doctors and patients assume normal LDL-C means low risk, but this shows you can have a dangerous number of particles even with acceptable cholesterol levels.
Practical Takeaways
Ask your doctor for an apoB test if you have a family history of heart disease or borderline cholesterol levels.
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Imagine each bad cholesterol particle as a truck carrying fat. ApoB counts the number of trucks, while LDL-C weighs the cargo. Some trucks carry more, some less. What matters most is how many trucks enter the artery wall, not how heavy their load is. So counting trucks (apoB) is better than weighing cargo (LDL-C).
Surprising Findings
LDL-C can be normal while apoB is high — meaning high heart disease risk despite 'good' cholesterol numbers.
Most doctors and patients assume normal LDL-C means low risk, but this shows you can have a dangerous number of particles even with acceptable cholesterol levels.
Practical Takeaways
Ask your doctor for an apoB test if you have a family history of heart disease or borderline cholesterol levels.
Publication
Journal
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Year
2022
Authors
Tamara Glavinovic, G. Thanassoulis, J. de Graaf, P. Couture, R. Hegele, A. Sniderman
Related Content
Claims (6)
Heart disease risk from clogged arteries is more about how many bad cholesterol particles are in your blood — counted by a protein called apoB — than about how much cholesterol is inside them.
Most of the 'bad' particles in your blood that can lead to heart disease are LDL, not the other kind (VLDL), because there are way more LDL particles floating around—even if you have high triglycerides.
You don’t need to fast before getting your apoB cholesterol test because eating doesn’t really change the levels — most of the particles measured come from your liver, not your recent meal.
ApoB is a better blood test for predicting heart disease than standard cholesterol tests because it counts the actual particles that clog arteries, while cholesterol numbers can be misleading since each particle carries different amounts of cholesterol from person to person.
The amount of cholesterol in each 'bad' particle in your blood can change because of a protein called CETP, which means counting cholesterol might not give the full picture of heart disease risk.