The Apolipoprotein Ratio: A Better Way to Measure Your Risk for Cardiovascular Disease

Heart disease has been the leading cause of death not just in the United States but in the world for decades. Despite billions of dollars of annual funding per year and the efforts of hospitals, clinics, doctors, and patients to prevent and decrease the risk for cardiovascular disease, nearly 700,000 people in the US die of heart disease each year.

While high levels of bad cholesterol (low-density-lipoprotein or LDL) can increase the risk of cardiovascular disease by causing plaque build-up in the blood vessels, the condition doesn’t only affect those with bad cholesterol. That means that relying solely on cholesterol tests might not be the most accurate way to evaluate your individual risk for cardiovascular disease.

Instead, some turn to an additional test to measure risk for cardiovascular disease: The apolipoprotein assessment.

What are apolipoproteins and what do they do?

Apolipoproteins are special proteins that carry lipids (fat), such as cholesterol, through the blood. The apolipoprotein assessment focuses on two specific kinds:

Apolipoprotein A-1 (also called ApoA-1) is a protein produced in the liver and intestines and found in good cholesterol (high-density-lipoprotein or HDL). It assists HDL in removing bad cholesterol from your body by initiating reverse cholesterol transport, or transporting extra amounts of cholesterol back to the liver for removal from your body. Eliminating this extra cholesterol contributes to lowering your LDL levels.

Meanwhile, apolipoprotein B (also called ApoB) is a protein found around bad cholesterol and is responsible for transporting those lipoproteins through the blood. Researchers at the Cleveland Clinic have found that one ApoB molecule carries one bad lipoprotein. That means that measuring ApoB levels can provide insights on the amount of bad cholesterol in the blood.

What is an apolipoprotein assessment?

An apolipoprotein assessment measures apolipoproteins A-1 and B and gives the ratio of both, providing a further glimpse into a patient’s risk of cardiovascular disease.

How is this assessment different than a cholesterol test? Levels of ApoA-1 and ApoB are less likely to vary over time than cholesterol levels, and studies have determined that the ratio of the two can identify patients at higher risk for cardiovascular disease even when those patients had normal cholesterol levels.

Because the apolipoprotein assessment is normally only used on patients who are at a higher risk for heart disease, most people aren’t aware it’s available as an additional way to test for cardiovascular disease. However, testing for it is so simple that it can easily be incorporated into any standard venipuncture lipid panel during a simple biometric health screening.

What can you do to lower your risk of cardiovascular heart disease?

Your annual physical with a primary care provider is a great starting place for figuring out where your health stands and what assessments are right for you. That’s why sharing your biometric health screening results with your primary care provider is an excellent way to better understand your health.

Their expert guidance can help you make lifestyle changes to lower your risk of cardiovascular disease, whether that’s focusing on a more nutritious diet, including physical activity in your day, getting enough sleep, and lowering stress. Maintaining healthy habits is one way to prevent conditions of all types and keep your cholesterol, blood pressure, glucose, and weight in check for a longer, healthier life.