{"id":36323,"date":"2026-09-05T10:15:00","date_gmt":"2026-09-05T14:15:00","guid":{"rendered":"https:\/\/www.ecoticias.com\/en\/?p=36323"},"modified":"2026-09-04T16:07:29","modified_gmt":"2026-09-04T20:07:29","slug":"millions-rely-on-ldl-cholesterol-tests-to-judge-heart-risk-but-a-new-study-suggests-apob-may-uncover-dangerous-particles-those-familiar-numbers-can-miss-and-could-help-prevent-more-heart-attacks-and","status":"publish","type":"post","link":"https:\/\/www.ecoticias.com\/en\/millions-rely-on-ldl-cholesterol-tests-to-judge-heart-risk-but-a-new-study-suggests-apob-may-uncover-dangerous-particles-those-familiar-numbers-can-miss-and-could-help-prevent-more-heart-attacks-and\/36323\/","title":{"rendered":"Millions rely on LDL cholesterol tests to judge heart risk, but a new study suggests apoB may uncover dangerous particles those familiar numbers can miss and could help prevent more heart attacks and strokes"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Every year millions of American citizens leave their LDL annual check ups with a question in their heads: \u201cis my \u201cbad\u201d cholesterol low enough\u201d? A new <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/41949879\/\" target=\"_blank\" rel=\"noopener\">study<\/a> published in the journal JAMA by Chicago\u2019s Northwestern Medicine suggests that the apolipoprotein B (apoB) could be doing a better job of guiding stronger cholesterol-lowering treatment, which could prevent more heart attacks and strokes at an ever lower cost.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The strength of the new evidence does correlate to LDL tests being useless. Since the research was a lifetime computer simulation and not a clinical trial the <a href=\"https:\/\/newsroom.heart.org\/news\/accaha-issue-updated-guideline-for-managing-lipids-cholesterol\" target=\"_blank\" rel=\"noopener\">2026 ACC\/AHA guideline<\/a> still keeps LDL-C and non-HDL-C as the main recommended treatments since the apoB efficiency is still unknown in human tests.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Why apoB sees something LDL can miss<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The standard <a href=\"https:\/\/www.cdc.gov\/cholesterol\/about\/ldl-and-hdl-cholesterol-and-triglycerides.html\" target=\"_blank\" rel=\"noopener\">LDL-C<\/a> that is used in the industry tells the physicians how much cholesterol is being carried inside the LDL particles. ApoB on the other hand serves as a count of harmful particles that carry cholesterol in the blood, in turn giving clinicians a better view of the traffic of particles that are going through the patient arteries.<\/p>\n\n\n\n<div class=\"gb-element-6f14a93e\">\n<div><div class=\"gb-looper-e42fa738\">\n<div class=\"gb-loop-item gb-loop-item-e81b02f7 post-36325 post type-post status-publish format-standard has-post-thumbnail hentry category-environment resize-featured-image\">\n<h4 class=\"gb-text gb-text-466026ea\">Read More: <a href=\"https:\/\/www.ecoticias.com\/en\/an-ohio-nuclear-plant-left-850-acres-untouched-for-safety-and-a-threatened-spotted-turtle-found-the-wetland-it-needed\/36325\/\">An Ohio nuclear plant left 850 acres untouched for safety, and a threatened spotted turtle found the wetland it needed<\/a><\/h4>\n<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">It is as if the LDL-C measured the cargo while apoB counted the trucks. Even if two people carried a similar amount of cholesterol the results can be different. For unknown reasons one person has more opportunities of having those cholesterol particles trapped to their artery walls contributing to the plaque.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-9-16 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Triglycerides vs LDL vs ApoB | Which Cholesterol Marker Predicts Heart Disease?\" width=\"563\" height=\"1000\" src=\"https:\/\/www.youtube.com\/embed\/XIvkDxGZZY8?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><figcaption class=\"wp-element-caption\"><em>YouTube: @dr.gluckswellnesscenter<\/em><\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">The computer model results are in<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Through a computer program researchers created a simulated cohort of 250,000 U.S. adults who were eligible for statins but that didn\u2019t have atherosclerotic cardiovascular disease. They compared treatment strategies using an LDL-C goal below 100 mg\/dL, a non-HDL-C goal below 118 mg\/dL, and\/or an apoB goal below 78.7 mg\/dL. If it happened that a simulated patient \u201cmissed the assigned target\u201d then the team tried using a statin first and an ezetimibe later if the statin didn\u2019t work.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">3 different strategies were combined over a simulated persons lifetime to try and estimate heart attacks, strokes, possibility of survival, quality of life and healthcare costs. The ApoB guided care produced well rounded results when the scientists took into account quality of life and life span. Breaking it down the researchers saw it added 1,324 years of a more quality adjusted life across the whole study population and that it also reduced a total cost of $40.2 millions all around. Equivalent to about $30,300 per year for each individual!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">The result comes with a caveat<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The study did not grab any 250,000 people and randomly assigned them to different blood tests. It was built using data of 4,149 people who had already participated in <a href=\"https:\/\/www.cdc.gov\/nchs\/nhanes\/index.html\" target=\"_blank\" rel=\"noopener\">federal health surveys<\/a> that were conducted between the years 2005 and 2016. Previously published research and other cohorts were then added to the mix by the scientists.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Which in turn means the findings are dependent on assumptions about future treatments, costs and cardiovascular risk. Most of the extra expenses came simply because people <a href=\"https:\/\/www.ecoticias.com\/en\/she-lived-to-be-117-years-old-eating-this-three-times-a-day-and-left-a-secret-hidden-in-his-dna-that-scientists-never-imagined\/30114\/\">survived longer<\/a>, giving them additional years in which they kept paying their preventive treatments.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">New guidelines open the door without replacing LDL<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/professional.heart.org\/en\/science-news\/2026-guideline-on-the-management-of-dyslipidemia\/top-things-to-know\" target=\"_blank\" rel=\"noopener\">new dyslipidemia guideline published in 2026<\/a> states that after LDL-C and non-HDL-C targets are met the apoB can help scientists assess possible risks before starting other therapies. It also shows people that have triglycerides above 200 mg\/dL, people that have <a href=\"https:\/\/www.ecoticias.com\/en\/that-lump-on-your-back-is-not-normal-a-buffalo-hump-could-be-an-early-sign-of-diabetes-high-cholesterol-or-liver-damage-and-almost-no-one-knows-how-to-spot-it-in-time\/31656\/\">diabetes<\/a>, and people with a very low achieved LDL-C (which is below 70 mg\/dL).<\/p>\n\n\n\n<div class=\"gb-element-de7acd89\">\n<div><div class=\"gb-looper-55a16da0\">\n<div class=\"gb-loop-item gb-loop-item-ecc33b6f post-24320 post type-post status-publish format-standard has-post-thumbnail hentry category-science resize-featured-image\">\n<h4 class=\"gb-text gb-text-4482f0fc\">Read More: <a href=\"https:\/\/www.ecoticias.com\/en\/images-captured-by-cameras-inside-the-arteries-show-how-certain-drugs-repair-the-heart\/24320\/\">Images captured by cameras inside the arteries show how certain drugs \u201crepair\u201d the heart<\/a><\/h4>\n<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">At the same time the guideline helped restore a clearer version of LDL-C and non-HDL-C treatment goals. It also determined that <a href=\"https:\/\/medlineplus.gov\/statins.html\" target=\"_blank\" rel=\"noopener\">statins<\/a> should be kept as the foundation of cholesterol lowering care. The apoB is not a replacement to a cholesterol treatment. It is instead positioned as an optional way for some patients who can probably still carry <a href=\"https:\/\/www.ecoticias.com\/en\/what-seemed-like-an-insignificant-genetic-detail-could-explain-why-some-older-men-develop-more-cardiovascular-diseases\/27798\/\">risky<\/a> previous LDL results.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Let\u2019s not get ahead of ourselves<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Jumping to conclusions based on this study alone is definitely not the way to go. Stopping a statin, changing a dose or dismissing the LDL result is not a good idea. What the patients need to ask themselves is if their apoB tests can add useful information to their risk assessment especially when they have elevated triglycerides, if they have diabetes, or if they have higher cardiovascular risks than the usual cholesterol numbers imply.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Because the blood test is only but a piece in the whole picture the clinicians also need to consider if the overall cardiovascular risk, health history and treatment tolerance are worth the benefits and burdens of an increase in medication.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">A small testing change can have a potentially large payoff<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The study lead <a href=\"https:\/\/www.globalhealth.northwestern.edu\/members\/profile.html?xid=59389\" target=\"_blank\" rel=\"noopener\">Ciaran Kohli-Lynch<\/a> stated the \u201cresearch shows that apolipoprotein B (apoB) is better at identifying who is at risk.\u201d His team\u2019s work also adds a financial argument to the biological case, suggesting that a more precise marker could financially aid American citizens that pay for healthcare to keep up with the costs.<\/p>\n\n\n\n<div class=\"gb-element-fef337b0\">\n<div><div class=\"gb-looper-9bf75b8e\">\n<div class=\"gb-loop-item gb-loop-item-f5d263b1 post-25876 post type-post status-publish format-standard has-post-thumbnail hentry category-trending-news resize-featured-image\">\n<h4 class=\"gb-text gb-text-b7fe93fc\">Read More: <a href=\"https:\/\/www.ecoticias.com\/en\/the-fda-is-recalling-a-major-and-popular-blood-pressure-medication-after-a-factory-error-added-a-suspicious-ingredient-that-should-not-have-been-there\/25876\/\">The FDA is recalling a major and popular blood pressure medication after a factory error added a suspicious ingredient that should not have been there<\/a><\/h4>\n<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Is it possible that an extra number on a lab report can show who needs to be more cautious before a possible first heart attack or <a href=\"https:\/\/www.ecoticias.com\/en\/the-zero-calorie-sweetener-that-could-affect-the-cells-that-protect-your-brain\/27030\/\">stroke<\/a>? There is no final evidence, but this study puts apoB closer to the routine clinical talks, and the cost question also creates another strong argument for it to be ignored.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This study was published in the journal <a href=\"https:\/\/jamanetwork.com\/journals\/jama\/article-abstract\/2847303\" target=\"_blank\" rel=\"noopener\"><em>JAMA<\/em><\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A study suggests the apoB blood test could guide cholesterol treatment better than LDL, adding healthy years and cutting costs.<\/p>\n","protected":false},"author":17,"featured_media":36375,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-36323","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-environment","resize-featured-image"],"_links":{"self":[{"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/posts\/36323","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/users\/17"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/comments?post=36323"}],"version-history":[{"count":2,"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/posts\/36323\/revisions"}],"predecessor-version":[{"id":36396,"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/posts\/36323\/revisions\/36396"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/media\/36375"}],"wp:attachment":[{"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/media?parent=36323"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/categories?post=36323"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ecoticias.com\/en\/wp-json\/wp\/v2\/tags?post=36323"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}