Not all LDL cholesterol is created equal. Some particles of this blood fat are large and buoyant and breeze easily through your circulatory system. But other particles are small and dense — and four times as likely to cause heart disease. "In order for cholesterol to cause disease, it has to embed in the wall of the artery," says Paul Ziajka, M.D., Ph.D., a clinical lipidologist with the Southeast Lipid Association. "And the smaller the particle, the easier it can do that."
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But before you swallow what your doctor prescribes, we suggest you read this article .
That means even a low cholesterol reading may not be an all-clear if you have predominantly small, dense LDL particles known as pattern B. For a quick indication, have your doctor check your triglycerides using a standard blood test. If your reading is over 200, you're probably pattern B, says Dr. Ziajka, which means you should lower your LDL cholesterol target another 30 points. (Calculate your recommended baseline LDL at aristos.com/ldl-target.php.)
But even a healthy triglyceride number isn't a free pass exempting you from coronary artery disease. The blood tests described below measure not only the amount of LDL coursing through your veins, but also its average particle size. Have your doc refer you to an area lab offering advanced lipid-profile testing; the referral often means a cheaper rate. And check out these seven ways to prevent heart disease.
1. LDL-S3 GGE test
Proteins from your blood are spread across a gel palette. As the molecules move from one end to the other, the gel becomes progressively denser. Large particles of LDL cholesterol can't travel as far as the small, dense particles can, Dr. Ziajka says. After staining the gel, scientists determine the average size of your LDL cholesterol particles. (Berkeley HeartLab, bhlinc.com, about $15 with insurance)
2. The VAP test
Your sample is mixed into a solution designed to separate lipoproteins by density. "The proteins in your blood have to find their equilibrium," says Dr. Ziajka. "Small, dense particles sink, and large, fluffy particles stay at the top." The liquid is stained and then analyzed to reveal 21 different lipoprotein subfractions, including dominant LDL size. (Atherotech, thevaptest.com, direct cost $40)
3. NMR lipoprofile test
Inside a magnetic field, radio waves charge the lipids in your blood. When the magnetic field is turned off, the protons give off energy, and that energy can be captured. Because energy emissions vary by particle size, this can be used to determine the type of LDL coursing through your veins. (LipoScience, lipoprofile.com, $100)
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