The Proof with Simon Hill Why you should test ApoB | Dan Soffer, Md
Lipoproteins' Role
- Lipoproteins carry lipids (cholesterol and triglycerides) through the bloodstream.
- These lipoproteins, not just the lipids themselves, are crucial in understanding atherosclerosis.
Residual Risk and ApoB
- ApoB helps assess residual risk, which is the risk of cardiovascular disease even with lowered LDL cholesterol.
- This residual risk can be due to factors beyond LDL, like high triglycerides or ApoB levels.
ApoB and Atherogenicity
- Atherogenic lipoproteins (VLDL, IDL, LDL, Lp(a)) contain ApoB, while HDL (non-atherogenic) has ApoA1.
- ApoB100 on liver-derived lipoproteins is the primary ligand for LDL receptors, crucial for clearing LDL from circulation.
Episode #339. Are you getting the full picture of your heart health? Learn why ApoB is the test you shouldn't skip. In this episode, I sit down with Dr Daniel Soffer, a preventive cardiologist and lipidologist, to break down the importance of ApoB testing for cardiovascular risk assessment.
You'll learn why ApoB provides more comprehensive insights than LDL cholesterol alone, who can benefit most from this test, and how it fits into preventive cardiology. Dr Soffer shares practical advice for assessing cardiovascular disease risk, discusses the implications of diet and genetics on heart health, and explores case studies to help you understand when and why ApoB testing is crucial.
Specifically, we discuss:
- Introduction (00:00)
- Insight into Preventive Cardiology and Lipidology (01:38)
- Understanding Lipoproteins and Their Role in Cardiovascular Disease (06:40)
- Techniques for Lipoprotein Testing and Measurement (11:33)
- Exploring Atherosclerosis and Lipoprotein Retention Hypothesis (31:18)
- Epidemiological Changes in Health and Cardiovascular Profiles (55:06)
- Concerns about the Keto Diet and Elevated ApoB Levels (58:26)
- Approaches to Managing Elevated LDL Levels Clinically (01:01:13)
- The Role of Evidence-Based Medicine in Cardiovascular Guidelines (01:07:15)
- Comparing ApoB and LDL Cholesterol in Cardiovascular Risk (01:14:36)
- Understanding Discordance in Lipid Measurements (01:18:36)
- Advanced Imaging Techniques for Risk Assessment (01:25:50)
- Guidelines and Considerations for Statin Therapy (01:44:30)
- Coronary Artery Calcium Score, Stroke Risks, and Carotid Ultrasound (01:54:03)
- Dietary Interventions and Carotid Intima-Media Thickness (IMT) (01:59:22)
- Case Study: Family History’s Role in Cardiovascular Risk (02:05:05)
- Overview of Statins, PCSK9 Inhibitors, and Other Lipid-Lowering Therapies (02:12:24)
- Aspirin Therapy and Imaging in Cardiovascular Health (02:26:06)
- Setting Treatment Thresholds Based on ApoB Levels (02:39:57)
- Closing Thoughts on Cardiovascular Risk and ApoB (02:44:16)
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Simon Hill, MSc, BSc (Hons)
Creator of theproof.com and host of The Proof with Simon Hill
Author of The Proof is in the Plants