Cardiovascular Disease - Bloody Good
Cholesterol & Blood Pressure

Apolipoprotein A1 + B

Check your heart risk with the Apolipoprotein A1 + B Test. ApoA1 is linked with good cholesterol, while ApoB is linked with bad cholesterol. This test may help give a clearer picture of heart and metabolic health than cholesterol alone.

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Apolipoprotein A1 + B

Seeking more precise cardiovascular risk assessment beyond standard cholesterol testing, especially if you have diabetes, metabolic syndrome, or family history of heart disease?

Overview

Think of apolipoproteins as your body's specialized delivery trucks that transport cholesterol through your bloodstream, giving doctors a much clearer picture of your heart health than standard cholesterol tests can provide. Apolipoprotein A1 (ApoA1) is like the captain of your cleanup crew – it's the main protein that powers HDL or "good" cholesterol as it patrols your arteries, picking up harmful cholesterol deposits and hauling them back to your liver for disposal. Meanwhile, Apolipoprotein B (ApoB) is found in all the troublesome cholesterol particles, including LDL "bad" cholesterol and other types that can stick to artery walls and create dangerous blockages.

What makes this test so valuable is that it actually counts how many cholesterol-carrying particles you have, not just how much cholesterol is floating around. You could have seemingly normal cholesterol numbers but still be at risk if you have too many harmful delivery trucks (high ApoB) or not enough of the cleanup crew (low ApoA1). The ratio between these two gives your doctor a precise snapshot of whether your cardiovascular system is properly balanced, making this test especially helpful for people with diabetes, metabolic issues, or those whose regular cholesterol tests look fine despite having heart disease symptoms or a family history of cardiovascular problems.

Reviewed by Dr. Vu Tran
Bloody Good’s Chief Medical Officer

Symptoms

You may benefit from this test if you experience:
Family history of heart attack before age 50 High cholesterol despite healthy diet Cardiovascular risk assessment

Purpose

Essential for individuals with diabetes, metabolic syndrome, or strong family history of cardiovascular disease. Important for people with normal cholesterol levels but other risk factors. Valuable for monitoring advanced lipid-lowering therapies and assessing cardiovascular risk in complex cases where traditional lipid panels may be insufficient.

How to prepare

Fasting for 9-12 hours recommended for most accurate results, though less critical than for triglycerides. Avoid alcohol for 24 hours before testing. Maintain usual medications unless specifically advised otherwise by your healthcare provider. Stay well-hydrated and avoid intense exercise before testing.

Understanding results

Normal ranges: ApoA1: 1.2-2.4 g/L (men), 1.3-2.6 g/L (women); ApoB: 0.5-1.2 g/L; ApoB/ApoA1 ratio: <0.9 (optimal), 0.9-1.2 (moderate risk), >1.2 (high risk). Low ApoA1 or high ApoB indicates increased cardiovascular risk. The ratio provides the most clinically relevant risk assessment, with lower ratios indicating better cardiovascular protection.

After the test

Discuss results with your healthcare provider to determine appropriate cardiovascular risk management strategies. Abnormal results may require lifestyle modifications, advanced lipid-lowering therapies, or more intensive cardiovascular monitoring. Consider additional cardiac risk assessments and regular follow-up testing to monitor treatment effectiveness.

Frequently Asked Questions

  • Standard tests measure cholesterol content, while apolipoprotein testing counts the actual number of cholesterol-carrying particles. You can have normal cholesterol levels but still have too many harmful particles (high ApoB) indicating increased risk.
  • A high ratio indicates an imbalance between harmful and protective cholesterol particles, suggesting increased cardiovascular risk even when total cholesterol appears normal. It's considered one of the most accurate predictors of heart disease risk.
  • Yes, this test can identify cardiovascular risk in people with normal cholesterol levels by detecting particle number imbalances that standard lipid panels might miss, particularly in diabetes and metabolic syndrome.
  • Lifestyle changes including regular exercise, Mediterranean-style diet, weight management, and avoiding trans fats can improve the ApoB/ApoA1 ratio. Some people may need advanced lipid-lowering medications.
  • This test can be valuable for people on statins to ensure optimal cardiovascular protection and guide treatment adjustments, especially if you have diabetes or multiple risk factors.
  • Typically every 1-2 years for monitoring, or more frequently if you have high cardiovascular risk, diabetes, or are adjusting treatment. Your doctor will recommend appropriate timing based on your risk profile.
Apolipoprotein A1 + B

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What to expect

We want you to feel bloody good—inside and out. Regular testing isn’t just about checking your current health; it helps you spot abnormal values you might not know about.

1

Book your referral

Choose the testing that suits your goals. After ordering, you will receive your referral by email.

2

Collect your sample

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3
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View your lab results and receive a personalised review from the secure Bloody Good platform.

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