In this episode, we compare Elton’s recommendations from his Rotary presentation to the 2026 Guideline on the Management of Dyslipidemia, a joint publication by the American Heart Association (AHA) and the American College of Cardiology (ACC). This update replaces the very dated 2018 recommendations and emphasizes earlier intervention through lifestyle changes and pharmacotherapy to reduce long-term cardiovascular risk.

ApoB, Lipoprotein(a), and C-reactive protein are the three tests that can help you prevent strokes and heart attacks that are often missed in standard blood work:

1. ApoB (Apolipoprotein B)

Superior Accuracy: ApoB is considered one of the best biomarkers for heart disease risk, as it measures the actual number of all atherogenic (plaque-forming) particles in your blood

Better than LDL: Traditional cholesterol tests measure the total weight of cholesterol, which can be misleading. Because particles vary in size, you could have a "normal" LDL cholesterol level but a dangerously high number of small, dense particles accumulating in your arteries

2. Lipoprotein(a) or Lp(a)

Hidden, Powerful Risk: Lp(a) is an inherited, highly dangerous cholesterol particle that carries inflammatory proteins and promotes blood clotting

. High levels can double or even triple your risk of a heart attack and greatly increase your risk for stroke and aortic valve stenosis

Once-in-a-Lifetime Test: Because Lp(a) is up to 90% genetically determined, it remains relatively stable throughout your life, meaning it generally only needs to be tested once

Expert Consensus: Cardiology guidelines increasingly recommend that everyone should have their Lp(a) checked at least once to identify high-risk individuals who would otherwise go unnoticed by standard lipid panels

3. hs-CRP (High-Sensitivity C-Reactive Protein)

Inflammation Marker: Inflammation is a key driver of atherosclerotic cardiovascular disease

Along with ApoB and Lp(a), measuring inflammation via hs-CRP is recognized by new guidelines from the American Heart Association and American College of Cardiology as a more accurate predictor of heart disease risk than traditional cholesterol markers.

Source: Gemini

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