QUando we make blood tests, we always focus on cholesterol. And maybe we breathe a sigh of relief if the values are “in the norm”. But today science tells us that it is no longer enough. To really understand if our heart is safe, more precise tools are needed. Among these there are two tests still little known, but fundamental: APOB and Lipoprotein (A), also called LP (A).
Cholesterol, what are the two exams to be done
Two complicated acronyms, it’s true. But behind them are hidden precious information, which can make the difference between effective prevention and only apparent tranquility.
APOB: counting particles, not just the quantity
APOB It is a protein present on the so -called particles “Bad cholesterol” (such as LDL, VLDL and IDL). Each particle has one, like a label. The more apob we have in the blood, the more the potentially dangerous particles that can penetrate the arteries and encourage the formation of plates. Even if LDL cholesterol appears “normal”, a high apob can indicate a risk More concrete and hidden.
Lipoprotein (a): the risk we inherit
There Lipoprotein (a) It is a variant of the ADL, with a different structure. AND connected to a genetic cardiovascular riskthat is, independent of diet, physical activity or lifestyle. Those who have high LP (a) values tend to have a increased risk of heart attacks and strokes, Because this particle not only favors the formation of plates, but makes it even more difficult to dissolve the clots. It is a bit like having a road with holes and at the same time obstacles that block the passage.
They do not always fall among those of routine, but the doctor can prescribe these exams easily (Getty Images)
Who should do these two specific cholesterol exams?
Not everyone must measure APOB and LP (A), but in some cases they are particularly useful:
- If there have been heart attacks or strokes at a young age
- If there was a “unexpected” cardiovascular event
- If cholesterol is normal, but there are other risk factors (such as hypertension, diabetes, visceral obesity)
- If a family hypercholesterolemia is suspected
How do they measure?
With a simple blood test. It does not always fall among those of routine, but the doctor can easily prescribe it.
For APOB, a value below 90 mg/dl And considered good in primary prevention; under 60 mg/dl for those who have already had a cardiovascular event.
For LP (A), values over 50 mg/dl (or 125 nmol/l) indicate increased risk.
Can these two values be lowered?
APOB can be reduced with lifestyle and drugs (such as statins, Ezetimibe or PCSK9-Inhibitor). For the LP (A), however, the possibilities are limited today. AND difficult to lower it with diet or physical activity, But new therapies are coming, including some of RNAs that could change things. While waiting, the focus remains that of keep the other risk factors under control.
Cholesterol: you need to know to choose (or not) therapy
Understanding your risk profile today allows us to act with more awareness. The good news is that we have more and more tools to do it. APOB and LP (A) are not exams to everyone, But in many situations they can prove to be precious allies to protect us before problems occur. After all, real prevention begins right from here: from what is still not seen, but that we can learn to recognize.
Who is Dr. Nicola Triglione
Dr. Nicola Triglione
Nicola Triglione, cardiologist and expert in prevention and longevity to Solongevity Clinic. I specialized at theNiguarda hospital in Milan and then I attended one Sports Cardiology Fellowship at the University of Washington (Seattle, USA), International Center of Excellence for Cardiology of Sport. Here I refined my skills in the screening of elite athletes, with particular attention to the prevention of sudden heart death.
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