From Awareness to Action: Testing ApoB and Lp(a) This American Heart Month

By Shannon Kasun, Neuroscience Specialist

February is American Heart Month—a national movement dedicated to raising awareness about the number one cause of death worldwide and in the U.S.: cardiovascular disease.

Cardiovascular disease encompasses a range of conditions that affect the heart and blood vessels, including coronary artery disease (CAD)—the most common form, caused by a buildup of plaque in the arteries—and cerebrovascular disease. These conditions restrict blood flow and oxygen delivery to the heart, brain, and other organs. As a result, they dramatically increase the risk of acute cardiovascular events such as heart attack and stroke. 

Cardiovascular disease accounts for approximately 1 in every 3 deaths across the globe (Di Cesare et al., 2024). And yet, an estimated 80% of cardiovascular disease—including heart disease and stroke—is preventable (World Heart Federation, 2026). 

Prevention begins with understanding your individual health status. While a standard lipid panel offers a basic snapshot of heart health and cardiovascular disease risk, it falls short of providing the full picture. Two powerful biomarkers are routinely missing from conventional lipid assessments: Apolipoprotein B (ApoB) and Lipoprotein(a) [Lp(a)]. These are indispensable pieces of your cardiovascular risk puzzle, yet they are frequently overlooked during a typical yearly physical.

ApoB is the primary protein component of atherogenic (plaque-promoting) lipoprotein particles, including the infamous. Each harmful particle, including LDL, VLDL, and IDL, carries exactly one ApoB molecule, making ApoB a direct and precise count of the total number of damaging particles in the bloodstream—far more accurate than the estimated LDL-C value from a standard panel.

A 2025 meta-analysis found ApoB superior to LDL-C in predicting atherosclerotic cardiovascular disease risk in 9 out of 9 studies. Research consistently shows that ApoB “is a better indicator of heart disease risk than an LDL cholesterol value,” which is often an estimate rather than a direct measurement (Harvard Health Publishing, 2025). Measuring ApoB is a critical step in more accurately assessing and mitigating your cardiovascular disease risk.

Lp(a) is a genetically determined, complex lipoprotein similar to LDL that deposits cholesterol in arteries, promotes plaque formation, and acts as an independent risk factor for atherosclerotic cardiovascular disease. Often described as “stickier” than standard LDL, Lp(a) more readily binds to artery walls, accelerating plaque buildup and inflammation, and increasing the risk of heart attack, stroke, and peripheral artery disease. Individuals with Lp(a) ≥75 mg/dL had an 88% higher risk of atherosclerotic cardiovascular disease and more than double the risk of incident stroke compared to lower levels (Fan et al., 2025). Because Lp(a) levels are predominantly genetically regulated, they do not meaningfully improve with lifestyle modifications such as diet, exercise, or weight loss—though these remain essential for managing other modifiable risk factors. Knowing your Lp(a) level is still crucial and typically requires only a one-time measurement. An elevated result highlights the need for more aggressive control of complementary risks, such as ApoB, LDL-C, blood pressure, smoking, and inflammation, to offset this residual threat.

This American Heart Month, empower yourself with a complete view of your cardiovascular risk. We encourage testing for these two essential biomarkers—ApoB and Lp(a)—to truly understand your heart health. Our Performance Lab Assessment features a comprehensive blood panel of 89 biomarkers, including ApoB and Lp(a), to highlight your strengths and pinpoint areas for optimization.

The first step in combating the world's leading cause of death is knowledge paired with action. You now have the information—take the next step toward better heart health.

References 

Di Cesare, Mariachiara et al. “The Heart of the World.” Global heart vol. 19,1 11. 25 Jan. 2024, doi:10.5334/gh.1288

Sehayek, Daniel et al. “ApoB, LDL-C, and non-HDL-C as markers of cardiovascular risk.” Journal of clinical lipidology vol. 19,4 (2025): 844-859. doi:10.1016/j.jacl.2025.05.024

Fan, Wenjun et al. “Lipoprotein(a) Atherosclerotic Cardiovascular Disease Risk Score Development and Prediction in Primary Prevention From Real-World Data.” Circulation. Genomic and precision medicine vol. 18,1 (2025): e004631. doi:10.1161/CIRCGEN.124.004631