There is been lots of controversy about the best test for assessing your risk for a heart attack. I am continually bombarded with inquiries about cholesterol and lipids. Statin-happy doctors look at a single test, your cholesterol, and, voila, you are cleared for a statin. But there is a much better test to determine your heart attack risk — and a better way to treat it than statins.
One test I like a lot better than a cholesterol lab test measures a lipid called apolipoprotein-B. Why? Your body absolutely needs cholesterol to function and to make your hormones and cell membranes. But the apo-B lipid is much worse than the bad LDL cholesterol you see in your lab tests. Apo-B enables cholesterol to penetrate into your arterial walls.
Now even the major heart journal Circulation agrees. It published the first prospective study to directly compare LDL, non-HDL cholesterol, and apo-B as risk factors. The researchers followed more than 51,000 male health professionals since 1986. They were checked every two years.
Then researchers compared 243 of them who developed heart disease to 496 age-matched controls that were free of disease. The baseline level of apo-B was the strongest predictor of heart disease (relative risk of 2.98). The concentration of non-HDL cholesterol was also highly correlated at 2.75. LDL cholesterol (the so called bad guy) was much less predictive at 2.07.
The authors wrote, The practical application of our findings would be to switch from assessing LDL and non HDL cholesterol to assessing apo-B instead. Amazingly, the lab test for Apo-B is not even considered at all by the National Cholesterol Education Program.
I consider the apo-B test far more important than your cholesterol levels. My editors father just had a massive heart attack and all his blood work was in great shape prior to the attack. However, his apo-B was not tested.
So I think its vital you get both apo-B and apolipoprotein-A1 together. Apolipoprotein-A1 is a good guy. Studies have shown that the ratio of apolipoprotein-A1 to apolipoprotein-B may correlate better with increased risk of coronary artery disease (CAD) than total cholesterol, and the LDL/HDL ratio.
If your apo-B is high or your apo-A1 is low, then you need to treat it. Fortunately, this is really easy. The treatment is the same as your alternative cholesterol treatments. These include policosanol (I recommend Healthy Resolves Advanced Cholesterol Formula), niacin, tocotrienols, and, of course, diet, exercise, and lifestyle changes.
If more aggressive treatment is needed for high apo-B, then red yeast rice (along with CoQ10) would be excellent to lower it. And, finally, essential phospholipids, which I cover in-depth in this months lead story, would cap off your treatment. EPL will restore a decrepit lipoprotein system to haul away cholesterol deposited in your arteries.
Ref: Circulation, 2005; 112.