Detecting any kind of blood vessel problems before they lead to a catastrophe is life-saving. This is what we call early detection – the primary purpose of creating our platform. It was estimated by WHO that 17,9 million people died from cardio-vascular cases in 2016, which accounts for 32% of all global deaths1. Of these deaths, 85% resulted from either a heart attack or a stroke. In more than half of these cases, diseases were clinically silent. Till the very day when heart attacks took away their lives they didn’t feel any pain in their chest, nor any heartbeat disorder, which could point to any heart problems. That is why today we will talk about monitoring and sustaining healthy lipid levels and the importance of doing so for healthy living. So, a lipid panel blood test helps to assess the four major risk factors for cardiovascular diseases: total cholesterol levels, LDL cholesterol, HDL cholesterol and triglycerides.
This article was last reviewed by Svetlana Baloban, Healsens, on January 4, 2022. This article was last modified on 9 May 2023.
Many tragedies can be avoided due to the existence of a few simple, safe and inexpensive lab tests. These tests are able to detect a cardiovascular disease long before it results in a heart attack or a blood stroke. Detect it when it is possible to prevent almost any disorders. Luckily, for taking the recommended medical tests neither big money nor doctors’ prescriptions or permissions are needed.
So, an effective program of early diagnosing is based on a combination of several blood tests, namely homocysteine levels and CRP lab tests, and radiological methods, including calcium score and coronary ultrasonography, which might be added into your Preventive Medicine health checklist.
The American Heart Association recommends that everyone over age 20 get a lipid panel blood test so you know what your levels are and can do something about them if you need to. The National Cholesterol Education Program (NCEP) recommends that adults have their cholesterol checked every 4-6 years2.
Cholesterol is the form of fat we need to make outer membranes of our body cells stable. However, doctors have noticed for many years that people with high cholesterol levels suffer from cardiovascular diseases more often.
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In fact, they have discovered recently that different forms of cholesterol (“good” and “bad” cholesterol) also play a role. High levels of total cholesterol, high levels of bad cholesterol or low levels of good cholesterol adversely affect the cardiovascular system. For example, LDL or “bad” cholesterol can stick to blood vessel walls. For many years it can be a major factor in artery obstruction and more specifically in hardening of arteries, the process known as atherosclerosis.
Narrow arteries of your heart can get spontaneous blood clots, causing heart attacks and strokes. And high levels of triglycerides in the blood are associated with higher risks of cardiovascular diseases (CVD), even though the exact reason for this is not clear.
Preventive guidelines for a lipid panel blood test among young adults differ, but experts agree on the need to screen young adults who have other risk factors for coronary heart disease: obesity, smoking, high blood pressure, diabetes, and family history.
Less than half of young adults who have these risk factors don’t get cholesterol screening even though up to a quarter of them have elevated cholesterol3.
Lipid Panel Results
Total Cholesterol Levels
Following the recommendations by the US National Cholesterol Education Program (NCEP) total cholesterol concentration should fall below 200 mg/dL (5.17 mmol/L). 200 – 239 range will be the upper limit, any numbers higher than 240 indicate a risk of cardio-vascular diseases twice as high as that indicated by numbers lower than 200. As a general rule, the higher the cholesterol levels, the higher the risk of cardiovascular disease, although cholesterol is not the only risk factor. However, some new scientific evidence suggests that the optimum total cholesterol should lie within the range of 160 to 180 mg/dL (4.6 mmol/L). This data is supported by some investigation, showing that lowering total cholesterol to these indexes may decrease the risk of cardiovascular cases. If your cardiac computed tomography (CT) or carotid artery ultrasound detected problems, you need to bring your total cholesterol down to these optimum levels.
More than 102 million American Adults (20 years or older) have total cholesterol levels at or above 200 mg/dL, which is above healthy levels. More than 35 million of these people have levels of 240 mg/dL or higher, which puts them at high risk for heart disease.
Low-density lipoprotein cholesterol or LDL Lab Test Results
LDL stands for low–density lipoproteins. It is sometimes called the “bad” cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries. An extra LDL, along with other substances, forms plaque. The plaque builds up in your arteries; this is a condition called atherosclerosis.
To define your own optimum LDL cholesterol you have to consider all risk factors from those listed below:
Serious risk factors:
- Diagnosed coronary heart disease
- Cardiometabolic syndrome
- Coronary artery calcium (calcium score) lower than 75 percentile for your age. This is an extra recommendation – it is not listed in NCEP.
If you found to have one or more serious risk factors, you are in the group of high risk and it’s time to come to grips with the fact that you have to lower your LDL-C levels.
NCEP recommends the maximum level of LDL cholesterol for this high-risk group is 100 mg/dL (2.58 mmol/L).
Key risk factors:
- Age: older than 45 for men, and older than 55 for women
- Cigarette smoking
- Cases of premature heart disease or cardiovascular disease cases among close relatives (parents, siblings, or children) (older than 55 for men or older than 65 for women)
- High arterial blood pressure (140/90 or higher, or if drugs are taken to normalize blood pressure)
- HDL levels below 40
- Calcium score higher than 25 procentile (this is an extra recommendation – it is not listed in NCEP).
If you have one or less key risk factors, then according to NCEP, your LDL levels must be lower than 160 mg/dL (4.14 mmol/L). At the same time if you have 2 or more risk factors, then you should keep your LDL levels below 130, and below 100 would be even better. People who belong to the high-risk group of getting a heart attack or a stroke recommended keeping LDL levels below 100. Some recent studies show (indicate) positive results when the numbers are kept under 70.
High-density lipoprotein cholesterol or HDL Lab Test results
HDL (high-density lipoprotein), or “good” cholesterol, absorbs cholesterol and carries it back to the liver. The liver then flushes it from the body. But the antiatherogenic properties of HDL cholesterol do not end there. Thus, HDL cholesterol has antioxidant properties and shows an anti-inflammatory effect4. In addition, HDL has the ability to increase glucose uptake by skeletal muscle and stimulate insulin secretion by pancreatic beta cells5.
So, high levels of HDL cholesterol can lower your risk for heart disease and stroke. HDL level below 40 mg/dL (or 1.03 mmol/L) is the main risk factor of cardiovascular disease. If HDL level is higher than 60 mg/dL, cholesterol of this type performs barrier function.
At the same time, HDL levels below 40mg /dL among men and below 50 mg/dL among women are the symptom of (indicate, point to) metabolic syndrome, which in its turn, is also a major risk factor for cardiovascular disease.
Note that there are several reasons for low HDL cholesterol. Thus, type 2 diabetes is commonly accompanied by a low level of high-density lipoprotein cholesterol. This contributes to the increased cardiovascular risk associated with this condition. In addition, overweight, obesity, smoking, elevated triglycerides (TG), and physical deficiency are among the main factors of low HDL.
As for physical activity, then a recent meta-analysis has provided some insights into how much exercise is required6. So, an increase in HDL concentration was apparent only in people who exercised for at least 120 minutes each week.
Triglycerides Lab Test results
Triglycerides are the main criteria indicating levels of fat in the blood. The high content of triglycerides combined with low HDL levels is considered a characteristic of metabolic syndrome. Often high levels of triglycerides result from high consumption of sugar-containing products and high glycemic index. The general population’s ideal triglyceride level is less than 150 mg/dL or less than 1.7 mmol/L7 by FDA. Anything over 500 mg/dL is considered very high. At this level, there is a high risk of developing pancreatitis (inflammation of the pancreas). This condition can lead to permanent tissue damage. It is usually accompanied by abdominal pain, which can be very severe.
Guidelines for triglyceride levels in healthy adults are:
- Normal: under 150 mg/dL
- Borderline high: 150-199 mg/dL
- High: 200-499 mg/dL
- Very high: 500 mg/dL or higher
HDL and triglycerides are metabolically connected and are often inversely related: As triglycerides go up, HDL goes down — and vice versa. But that isn’t always so. People can have “isolated” high triglycerides without low HDL levels, and research is now showing that high triglycerides are an independent risk factor for cardiovascular disease, no matter what the HDL is8.
Lipid Panel Blood Test With Additional Additional Classes
Some labs provide advanced cardiovascular and lipid panel blood test that go beyond typical cholesterol testing to uncover risk factors for early heart disease.
As you can see there are two new components are added to this test: Lp(a) and ApoB. Lp(a) (also called Lipoprotein(a) is a lipoprotein subclass. Genetic studies and numerous epidemiologic studies have identified Lp(a) as a risk factor for atherosclerotic diseases such as coronary heart disease and stroke. It is similar to low – density lipoprotein (LDL, the “bad” cholesterol) in that it contains a single apolipoprotein B protein along with cholesterol and other lipids. This test measures the amount of Lp(a) in the blood to help evaluate a person’s risk of developing cardiovascular disease (CVD).
ApoB and ApoA-I are the two major apolipoproteins involved in lipid transport and in the processes causing atherosclerosis and its complications. ApoB is the main protein found in the low-density lipoproteins (LDL). Apo B increases this clogging, so your Apo B level may be a better indicator of cardiovascular risk than even LDL cholesterol.
Using the VAP Test tas Lipid Panel Blood Test
So, VAP test or Vertical Auto Profile provides even more detailed information about lipid levels as opposed to conventional examination, since this lab test directly assesses LDL levels. Traditional tests on the other hand measure only total cholesterol, HDL and triglyceride levels, and then use them to calculate LDL levels using these numbers. However, this is not the only advantage of VAP test, as this test gives additional information about the size and a current number of LDL particles, as well as tells about the number of less dangerous, large and spongy A-particles, and more dangerous small and dense LDL B-particles present in your body. Light and spongy A-particles easily push off the artery walls. On the other hand, small and dense B-particles are destructive and easily penetrate artery walls. An elevated number of small B-particles is often found among patients suffering from diabetes or metabolic syndrome.
Components of Lipid Panel Blood Test
- HDL2 and HDL3 subfractions
- Pattern A or B LDL
- VLDL cholesterol
- LDL-R (real)
- Lp (a)
- Remnant lipoprotein
Very low-density lipoprotein (VLDL) cholesterol is a type of fat in the blood. It is considered one of the “bad” forms of cholesterol, along with LDL cholesterol and triglycerides. This is because high levels of cholesterol can clog arteries and lead to a heart attack.
Normal VLDL cholesterol levels range from 2 to 30 mg/dL (0.1 to 1.7 mmol/L).
Because VAP measures additional lipoprotein classes, such as Lp(a), IDL, and subclasses of HDL, LDL, and VLDL, it can identify patients at high risk for coronary heart disease who cannot be identified using the standard lipid panel blood test. In addition, the VAP method is compliant with the National Cholesterol Education Program’s Adult Treatment Panel III guidelines.
Thus, if your lipid levels don’t meet the norms, you should take this test more often, say every four or six months, until you achieve the results you wish.
What to do if your lipid profile is outside the healthy range?
Self-treatment with a balanced diet and regular physical activity can help lower the levels of lipoproteins. If your lipid profile needs correction, consider the following recommendations to reduce the risk of cardiovascular diseases:
- Quit smoking if you smoke. Smoking is a major risk factor for cardiovascular diseases. The risk of coronary heart disease, stroke, heart failure, or peripheral vascular disease is two to six times higher in smokers compared to non-smokers.
- Follow dietary recommendations to reduce the risk of cardiovascular diseases, such as the “five-wheel” approach. The most important nutrients influencing this risk are saturated fatty acids (which increase LDL cholesterol levels compared to unsaturated fatty acids), salt (which raises blood pressure), and fiber (which reduces the risk of cardiovascular diseases). Vegetables, fruits, fish, and unsalted nuts also lower the risk of cardiovascular diseases.
- Allocate at least 150 minutes per week to moderate-intensity exercises such as walking or cycling. Integrate physical activity into your daily life. Increasing the duration, frequency, and/or intensity of exercises will provide additional health benefits.
- Include strength and bone-strengthening workouts at least twice a week, especially for older adults.
- Avoid excessive sitting (more than eight hours a day).
- Maintain a harmonious psycho-emotional state.
Regarding medications, your doctor may prescribe statins such as simvastatin, lovastatin, atorvastatin, and rosuvastatin. These are well-studied drugs that not only lower LDL cholesterol levels but also have a positive impact on blood vessels.
Your doctor will strive to achieve specific cholesterol levels, typically LDL cholesterol levels below 2.6 mmol/L. Additionally, any side effects will be carefully evaluated. If side effects occur, an alternative medication or a reduction in statin dosage may be offered.
People who couldn’t reach their goals for cholesterol levels taking statins may need high doses or additional medications. Other non-statin drugs include ezetimibe and, less commonly, fibrates or niacin.
Additionally, you can consider some beneficial food supplements. They can also dramatically lower your cholesterol and triglyceride levels. Looking ahead we can say that nutritional supplements work independently and can be used with statins. But we’ll expand on that that in the following articles.
And finally, if you are not ready to start statin therapy or want to understand your risks and potential benefits, there are additional tests. We are talking about such medical research as the calcium index of the coronary arteries or computed tomography of the heart. It is worth clarifying that intimal thickness assessment is no longer recommended for CVD risk assessment. So, for example, atherosclerotic plaques can occur in the absence of thickening of the intima-media9.