HEALTHY LIVING
Cholesterol Test Your Doctor May Not Order, but Should
lipids. Research indicates it is a better predictor of heart attack risk. In a recent study published in the
European Heart Journal, researchers analyzed 200,000 participants in the U.K. who had no history of heart disease, focusing on two of these particles: apolipoprotein B (apoB) and lipoprotein(a). The participants, who had normal cholesterol levels at the start, were followed for 15 years, during which time 3.7% of them developed coronary heart disease. Researchers found that apoB was
the largest predictor of coronary heart disease. Although lipoprotein(a) could play a role as well, this was found in a smaller number of people, and it depended on their genetic risk. “While I have used this test for
This advanced check is a better predictor of heart attack risk. :: BY CHARLOTTE LIBOV
C
ardiologist chauncey Crandall, M.D., was confused by one of his heart attack patients recently.
She didn’t look like a typical cardiac
patient as she was slim, exercised daily, and was meticulous about eating a healthy diet. Most puzzling of all, her cholesterol profile was normal. So he ordered a second cholesterol
test, and this one provided him with the answer he was seeking. Although the first test showed normal cholesterol levels, the second one, a more detailed assessment of the cholesterol particles and their distribution, actually indicated a high heart disease risk. Research is now confirming what
Crandall, director of preventive medicine at the Palm Beach Cardiovascular Clinic in Florida, has known for years. The first test, which is the one
84 NEWSMAX MAXLIFE | OCTOBER 2025
that millions of us get annually, does not provide enough information. For many, a second, newer test is needed to accurately ascertain risk. “The standard cholesterol test
has been our gold standard for nearly 60 years, and I think it’s time to leave it behind,” Crandall tells Newsmax magazine. In atherosclerosis, the disease
process that causes coronary heart disease, elevated levels of cholesterol in the blood create fatty deposits that line the coronary arteries. This narrows them, and sets the stage for a heart attack-causing blood clot. The standard cholesterol test,
which also includes triglycerides, is called a lipid profile or lipid panel, measuring the levels of these different types of fats (lipids). It divides the cholesterol into two categories: LDL (low-density lipoprotein), so-called “bad” cholesterol; and HDL (high- density lipoprotein), the “good” cholesterol. But a newer test, known as an advanced lipid test or panel, goes beyond this standard version, providing information about the particles that make up the different
years on certain individuals, research like this could help make it the standard screening test for everyone,” Crandall says. Nowadays, this advanced lipid
profile is a separate test that can be ordered in addition to the standard one; all patients need to do is ask their doctor for it, and it will usually be covered by insurance, Crandall notes. “The problem is many doctors
don’t know about this test or, if they do, they don’t understand it,” he says. Another issue is that
these lipoprotein levels are “nonmodifiable,” meaning that you can’t change them — but still, such knowledge is important because it underscores to patients that they must focus on doing all they can to lower their heart disease risk. “You need to make sure that all of your risk factors are at target,” Crandall says. “You need to be at your ideal weight, eating healthy and exercising, and that your blood pressure and blood glucose levels are at target. “Your total cholesterol should
be 150 or less, and your LDL- cholesterol should be less than 50. If you do all of this, even if you have these abnormal lipoprotein levels, they won’t increase your likelihood of developing heart disease.”
TEST/LUCHSCHENF©ISTOCK /DOCTOR/PONYWANG©ISTOCK
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