Most people have a standard lipid profile complete every year or two to help them and their doctor assess their risk for cardiovascular disease. These panels look at total cholesterol, HDL cholesterol, LDL (calc) cholesterol and triglycerides.
However, research shows that 50% of people that have heart attacks have “normal” standard lipid markers. How accurate can a test be if it misses 50% of the people that have heart attacks? That’s the same as flipping a coin to assess “risk”!
It doesn’t take much digging to find out why these inaccuracies exist. First, the equation used for these tests is inaccurate; it states that
Total cholesterol (TC) = VLDL + LDL + HDL
VLDL = very low density lipoproteins
LDL = low-density lipoproteins
HDL = high-density lipoproteins
LDL is estimated to equal triglyceride (TG)/5, therefore
LDL Calculated = TC – (HDL+TG/5)
The problem is the constant “5” in the above equation actually varies between about 2 and 10 in real life, which results in and LDL Calc number that is incredibly inaccurate.
Once more, there are many different LDL particles (at least six subclasses are known); some are very atherogenic (i.e., cause atherosclerosis) while others are not. Thus, it matters what type of LDL particles are present in each person to get a better assessment of risk.
And it doesn’t stop there. It turns out that the LDL particles themselves, and not the cholesterol they contain, are more important in determining cardiovascular disease risk (you can find out more here).
I know this can start to sound pretty heady, but the bottom line is this: standard lipid panels do not give you the information you need to accurately assess your cardiovascular disease risk. The best test that I have seen (and use) for this purpose is called a Lipoprotein Particle Profile Plus (LPP+); it measures a wide array of markers known to correlate with cardiovascular disease/health and can provide a much more accurate assessment of cardiovascular disease risk than standard lipid panels.
If you’d like to run this test and don’t have a provider in your area, we can arrange to have it done for you; please contact us for more information.