The Most Important Tests to Assess Your Risk of Heart Disease That Your Doctor Doesn’t Check

Heart disease is still the number one killer in the world, yet most people don’t actually understand what markers put them most at risk. The general consensus is there are two types of cholesterol—the good and the bad—the good is thought to be high-density lipoproteins or HDL, and the bad is low-density lipoproteins or LDL. But we now know from research that it's much more complicated than that—there are actually various sizes and densities of these lipoproteins.

Today on The Doctor’s Farmacy, I’m excited to talk to one of the leading lipidologists, Dr. Ronald Krauss, all about lipoproteins, what they do in the body, what they mean for heart disease risk, and why a typical lipid panel alone is insufficient. We kick off our conversation by talking about how standard cholesterol testing is outdated. This is because it doesn’t check for particle size and particle number, information that is needed to tell what’s really going on with your cholesterol.

We also discuss the misconception that dietary cholesterol plays a large role in blood cholesterol, and what effect eating saturated fat versus refined carbohydrates has on LDL particle size and heart disease risk. Statins have become the panacea for anyone with LDL levels that are just a little off, yet most people (and even many doctors) aren’t fully informed of the risks versus the benefits of these drugs, let alone aware of other treatment options for heart disease.

Dr. Krauss and I talk about how statins can be a reliable therapy for lowering cardiovascular risk, however, they may be less effective in reducing small, dense LDL particles.

We also discuss the assay Dr. Krauss developed to differentiate between the sizes of lipoproteins that carry cholesterol, what they mean for heart disease risk, what numbers raise a flag, and what other biomarkers should be tested alongside lipoprotein fractionation. I hope you’ll tune in to learn more.

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