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Heart disease is the leading cause of death for both men and women in the U.S.
According to Dr.Thomas Dayspring, a fellow of the National Lipid Association and a renowned cholesterol expert, hardening of the arteries caused by a buildup of plaque-producing particles is best evaluated using the apoB test.
“ApoB is by far the best metric that every human should get tested for when they do their cardiovascular risk assessments,” Dayspring said last fall during an appearance on the “Proof with Simon Hill” podcast.
An apoB test looks directly at the number of artery-clogging particles in the blood. “LDL cholesterol is telling me how much cholesterol is carried by the LDL particles, and apoB is telling me how many of the LDL particles I have,” said Dr. Anne Nora, a researcher at Massachusetts General Hospital.
Dr. Jeffrey berger, a preventive cardiologist at NYU Langone, said “apoB offers a practical and thorough way to basically assess cholesterol burden,” which is involved in the accumulation of bad cholesterol and plaque formation.
However, apoB testing remains uncommon. A 2024 study sponsored by Regeneron and published in The American Journal of Preventive Cardiology found that less than 1% of U.S. adults had been tested for apoB.
ApoB testing is gaining traction among health influencers and is increasingly offered in the direct-to-consumer blood testing market. Recently, the Sweetgreen salad chain – which has partnered with anti-seed-oil influencers – launched a collaboration with the testing company Function Health, promoting apoB screening alongside its menus.
Dr.Michael Shapiro, a preventive cardiologist and the chair of the American Heart Association Council on Lipidology, Lipoprotein, Metabolism & Thrombosis, said that he typically uses an apoB test in select patients.
“I think the best use case is when you’re treating somebody with lipid-lowering therapy,” he said,referring to medications such as statins,which are taken to lower cholesterol. “Maybe you’ve gotten them to the LDL cholesterol you were trying to get them to and now you want to adjudicate whether they’ve really gotten to the goal that you want them to get.”
Insurance coverage for apoB testing varies. If not covered, the test typically costs around $70-$150 at a lab, depending on location and provider.
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