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ApoB – Another Way to Assess Heart Health
Measuring your LDL levels is the most common way to assess your levels of “bad cholesterol” and risk of heart disease. However, there is another important factor that doctors are starting to pay attention to: Apolipoprotein B (ApoB). But what exactly is it and how does it affect us?
What Is ApoB?
ApoB (short for Apolipoprotein B) is a protein found on particles that carry cholesterol and fat in your blood. These cholesterol particles can cause plaque to build up in blood vessel walls, resulting in blockage of the blood vessels. Once a blood vessel in the heart or brain is blocked, a heart attack or stroke can occur.
The risk of a heart attack or stroke increases as the level of ApoB in the bloodstream increases.
Every “bad” cholesterol particle like LDL, VLDL, and IDL contains exactly one ApoB molecule. Measuring ApoB therefore tells us how many of these particles are circulating in the bloodstream.
ApoB vs. LDL: What's the Difference?
| LDL-C (Low-Density Lipoprotein Cholesterol) | ApoB (Apolipoprotein B) |
|---|---|
| Measures the amount of cholesterol in LDL particles. LDL is the most common cholesterol particle in our bloodstream. | Measures the number of cholesterol-carrying particles in the bloodstream. |
In most people, LDL-C and ApoB are very closely related.
In fact, international guidelines still recommend lowering LDL-C as the primary way to reduce risk of heart disease and stroke.
However, LDL-C may underestimate the real cardiovascular risk in the following groups of patients:
- Diabetes
- Obesity
- High triglyceride levels
- Metabolic syndrome
- Very low LDL-C levels (on cholesterol-lowering meds)
In these situations, you could have more harmful cholesterol particles than your LDL-C suggests—making ApoB a more useful marker.
What is a healthy ApoB level?
The European Society of Cardiology (ESC) 1 suggests these targets for ApoB levels:
| Risk Level | Target ApoB Level |
|---|---|
Very high cardiovascular risk:
|
< 65 mg/dL |
High cardiovascular risk:
|
< 80 mg/dL |
| Moderate cardiovascular risk | < 100 mg/dL |
If you are interested in learning more, speak to us in clinic about whether ApoB testing is suitable for you and how to better manage your cardiovascular risk. Regular health screenings remain important—whether through LDL testing alone or with ApoB—while maintaining a healthy lifestyle, including a balanced diet and regular exercise, continues to be the cornerstone of preventing heart disease and stroke.
Book an appointment to assess your cardiovascular risk today!
Reference:
- Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., Graham, I. M., Halliday, A., Landmesser, U., Mihaylova, B., Pedersen, T. R., Riccardi, G., Richter, D. J., Sabatine, M. S., Taskinen, M. R., Tokgozoglu, L., … ESC Scientific Document Group (2020). 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. European heart journal, 41(1), 111–188. https://doi.org/10.1093/eurheartj/ehz455
Author
Dr Amaris Lim
MBBS, MMed (Fam Med), GDip (Sports Med)
Dr Amaris is a Family Physician at Frontier Healthcare with a special interest in Sports Medicine. She also contributes as one of the Core Faculty for the Family Medicine Residency Program with the National University Health System (NUHS). She currently practices at Canberra and Bukit Batok.
