Heart Surgeon Explains Difference Between LDL-C And ApoB In Heart Attack Risk Assessment

A heart health expert has highlighted that individuals with normal cholesterol readings may still be at risk of heart disease, including heart attacks, stressing that standard lipid profiles do not always provide a complete assessment of cardiovascular risk. The clarification was shared by Dr Jeremy London, a board-certified cardiothoracic surgeon with over 25 years of clinical experience, in a video posted on June 13. In his explanation, he addressed a common misconception that normal cholesterol levels automatically indicate a low risk of heart-related complications.

Dr London noted that conventional cholesterol tests, often referred to as lipid panels, primarily measure LDL-C (low-density lipoprotein cholesterol), which is commonly labelled as “bad cholesterol.” However, he explained that this measurement does not fully capture the number of atherogenic particles circulating in the blood, which play a critical role in plaque formation within arteries.

He further pointed to Apolipoprotein B (ApoB) as a more precise biomarker for assessing cardiovascular risk. According to his explanation, ApoB reflects the total number of potentially harmful lipoprotein particles in circulation, offering a more detailed view of a person’s likelihood of developing atherosclerotic cardiovascular disease compared to LDL-C alone.

Also Read: Doctor Shares 5 Heart Attack Symptoms Women Should Watch For Early Detection

Dr London emphasised that individuals can sometimes have normal LDL-C levels but elevated ApoB levels, meaning their actual risk may be higher than what standard tests suggest. This discrepancy, he noted, is why some patients experience cardiovascular events despite previously being told their cholesterol levels are within a normal range.

Medical experts broadly agree that cardiovascular risk assessment is multi-factorial and cannot rely on a single marker. Factors such as blood pressure, inflammation, diabetes status, lifestyle habits, and family history also contribute significantly to overall risk, alongside lipid-related measurements. The discussion around ApoB has gained increasing attention in recent years as clinicians seek more accurate tools for predicting heart disease.

While LDL-C remains widely used in routine screening, ApoB is increasingly being recognised as a valuable supplementary test in more detailed cardiovascular evaluations. Dr London’s comments aim to raise awareness that “normal cholesterol” does not always equate to “low risk,” encouraging more comprehensive screening approaches for individuals concerned about heart health or those with additional risk factors.

Also Read: UK Nutritionist Warns Rice May Contain Arsenic, Shares Safer Cooking Method