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<v Speaker 1>Afternoon, everybody, and welcome. It is June sixteenth. I've been

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<v Speaker 1>off for a couple of days. I had the opportunity

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<v Speaker 1>of my son and his wife come and stay with

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<v Speaker 1>us for four or five days. It was wonderful, went

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<v Speaker 1>to the beach, went to a concert, did a bunch

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<v Speaker 1>of different things, and it was nice to reconnect. So

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<v Speaker 1>I was out of it. I didn't do any podcasts

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<v Speaker 1>during that time. I apologize, but we're going to get

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<v Speaker 1>back to it now. A new article came out today

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<v Speaker 1>talking about testing for cardiovascular disease problems, so we'll talk

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<v Speaker 1>today about a new test that may help you in

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<v Speaker 1>your battle with cardiovascar disease. Stay tuned, hi, and welcome

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<v Speaker 1>to Health Talk with Doctor Lynn. Your daily dose. The

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<v Speaker 1>information you hear on the show is informational. It's not

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<v Speaker 1>meant to diagnose or treat any disease. Any kind of

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<v Speaker 1>complete health conditions must be checked out and discussed with

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<v Speaker 1>your primary care physician. Get ready for the good news

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<v Speaker 1>of the day. God bless you, folks, and here is

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<v Speaker 1>doctor Lynn. Our daily devotional today comes from the Book

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<v Speaker 1>of Ephesians, Chapter two. Stay on the high road with me.

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<v Speaker 1>Many voices clamor for your attention, trying to divert you

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<v Speaker 1>to another path. But I've called you to walk over

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<v Speaker 1>so closely with me, soaking in my presence, living in

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<v Speaker 1>my peace. This is my unique design for you, planned

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<v Speaker 1>before the world began. I have called each of my

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<v Speaker 1>children to a different path, distinctly designed for that one.

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<v Speaker 1>Do not let anyone convince you that his path is

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<v Speaker 1>the only right way. Be careful not to extol your

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<v Speaker 1>path as superior to another's way. What I require of

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<v Speaker 1>you is to act justly, to love mercy, and to

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<v Speaker 1>walk humbly with me wherever I lead.

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<v Speaker 2>Stay tuned tin.

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<v Speaker 3>Seven two seven nine one six four two one five

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<v Speaker 3>to get a hold of me.

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<v Speaker 1>Off air. Cholesterol testing, we all get it done almost

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<v Speaker 1>on a regular basis. There's one test that very few

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<v Speaker 1>of you really get. It's been a part of the

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<v Speaker 1>Boston heart screening that I've been doing with patients now

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<v Speaker 1>for the last twenty years, and it's now coming to

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<v Speaker 1>the surface as one of the most widely recognized now

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<v Speaker 1>and maybe a better test than just testing your total cholesterol.

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<v Speaker 1>It's cap called apo lipoprotein B. Two people can have

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<v Speaker 1>the same cholesterol level but very different heart disease risk.

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<v Speaker 1>A simple test may explain why for some people a

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<v Speaker 1>normal cholesterol reading doesn't always mean there's something to worry about.

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<v Speaker 1>For about the price of a dinner out. A simple

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<v Speaker 1>blood test can reveal a hidden layer of heart disease

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<v Speaker 1>risk that standard cholesterol tests miss, Yet it isn't part

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<v Speaker 1>of routine cholesterol screening, so most doctors don't order because

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<v Speaker 1>they don't have a drug for it. The test measures

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<v Speaker 1>apo lipoprotein B or APO B, a protein that sits

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<v Speaker 1>on every particle that carries cholesterol through the bloodstream, sort

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<v Speaker 1>of like a little truck. Unlike standard cholesterol tests, which

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<v Speaker 1>measure how much cholesterol is circulating, ApoB counts the actual

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<v Speaker 1>number of those harmful particles. Two people can have the

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<v Speaker 1>same LDL or bad cholesterol level, but the one with

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<v Speaker 1>more APO B containing particles are at our higher cardiovascular risk,

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<v Speaker 1>said doctor Zang Zhang At, assistant professor at Columbia University.

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<v Speaker 1>Standard cholesterol tests focus largely on LDL, the so called

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<v Speaker 1>bad cholesterol, along with high density lipoprotein HDL. Higher levels

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<v Speaker 1>of LDL and the blood are linked to an increased

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<v Speaker 1>risk of heart attack and strokes, and for decades clinicians

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<v Speaker 1>have used LDL L is their only and primary guide

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<v Speaker 1>for treatment. Whoever, Heart disease risk is not about the

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<v Speaker 1>amount of cholesterol present. It also depends on the number

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<v Speaker 1>of cholesterol carriers. The number matters because these particles are

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<v Speaker 1>not the same size. Smaller LDL particles can produce LDL readings,

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<v Speaker 1>but a higher total number of harmful particles overall, a

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<v Speaker 1>pattern associated with increased athoskerotic cardiovascar disease. An APPOB test

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<v Speaker 1>closes that gap because each particle carries exactly one ApoB

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<v Speaker 1>protein attached to it. Measuring ApoB gives you a direct

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<v Speaker 1>count of how many harmful or atherogenic particles those capable

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<v Speaker 1>burrowing into artery walls and depositing plaque, are circulating in

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<v Speaker 1>the blood. When ApoB levels are higher than expected relative

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<v Speaker 1>to your LDL levels, this mismatch is called discordance. Remember

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<v Speaker 1>that name discordance. In these cases, low or normal cholesterol

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<v Speaker 1>measures maydical reassuring, but they can give a false sense

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<v Speaker 1>of security. More particles circulating the blood means more opportunities

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<v Speaker 1>for them to contribute to plaque build up. Over time.

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<v Speaker 1>These plaques eventually restrict blood flow and can lead to

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<v Speaker 1>heart attacker strokes. Alternatively, having lower normal APPO B levels

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<v Speaker 1>even in people with high LDL predicts a lower likelihood

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<v Speaker 1>of plaque build up and a lower risk of athos choruses.

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<v Speaker 1>So you can have a high LDL, have been a

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<v Speaker 1>normal APPO B and not be at a cardiovascidar risk

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<v Speaker 1>if you have a family history of early heart disease,

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<v Speaker 1>of B CITY or other metabolic risk factors. Apo B

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<v Speaker 1>may offer additional information beyond standard LDL cholesterol tests. Beyond

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<v Speaker 1>helping to identify risks that might otherwise be missed, APPO

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<v Speaker 1>B can also help doctors decide how aggressively to treat

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<v Speaker 1>that risk. As a study published in JAMA, computer model

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<v Speaker 1>stimulate simulating about two hundred and fifty thousand US adults

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<v Speaker 1>eligible for statins compared three ways of guiding cholesterol lowering

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<v Speaker 1>treatment by LDL cholesterol, by non HDL cholesterol, or ApoB.

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<v Speaker 1>They found that by using APPO B to guide treatment

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<v Speaker 1>decisions gave the greatest overall benefit. Let me read that again.

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<v Speaker 1>They found that using APPO B to guide treatment decisions

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<v Speaker 1>gave the greatest overall benefit. ApoB tests may be especially

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<v Speaker 1>useful for assessing heart disease risk in younger adults. In

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<v Speaker 1>another study published in JAMA Network, they followed ten thousand

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<v Speaker 1>adults for roughly two decades. Drawing on data from three

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<v Speaker 1>large US cohort studies. They examined how well different cholesterol

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<v Speaker 1>markers predicted future heart attacks and strokes. Higher APPO B

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<v Speaker 1>levels were associated with the greater heart disease risk and

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<v Speaker 1>stroke across all age groups. However, the marker was especially

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<v Speaker 1>informative in younger adults aged eight to thirty nine, with

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<v Speaker 1>a risk gap between the high and low apo B

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<v Speaker 1>levels was four times greater than in older adults. We

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<v Speaker 1>found that APPO B may be more informative in younger adults.

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<v Speaker 1>Adding APPO B to standard risk equations modestly improve the

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<v Speaker 1>quality and the ability to identify which younger adults would

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<v Speaker 1>go on to develop party of ascer disease. APPO B

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<v Speaker 1>tests are relatively inexpensive, usually around sixty bucks through most

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<v Speaker 1>major lab providers, but they are still not part of

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<v Speaker 1>a routine cholesterol screening. One reason is practical, The test

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<v Speaker 1>usually has to be ordered separately rather than included in

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<v Speaker 1>a standard lipid panel, and doctors are lazy. It's also

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<v Speaker 1>the question of habit. For decades, clinicians of a rite

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<v Speaker 1>relied on LDL cholesterol assess risk and guide treatment, and

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<v Speaker 1>shifting to a different approach can take time, even as

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<v Speaker 1>evidence continues to build that may be starting to change.

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<v Speaker 1>Current US guidelines still use the LDL cholesterol thresholds of

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<v Speaker 1>less than one hundred for borderlined intermediate risk, less than

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<v Speaker 1>seventy for high risk, less than fifty five for people

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<v Speaker 1>with very high heart disease risk. However, health organizations, including

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<v Speaker 1>the American Heart Association, increasingly emphasizing earlier diventions and new

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<v Speaker 1>cardiovascular risk tools, are beginning to take a broader view

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<v Speaker 1>of risk beyond LDL cholesterol alone. LDL and non HDL

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<v Speaker 1>cholesterol still provide useful information, but APPOB is more directly

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<v Speaker 1>tied to heart attack risk because it reflects the number

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<v Speaker 1>of harmful cholesterol particles in the blood. For some people,

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<v Speaker 1>especially those with diabetes, fatty liver disease, or obesity. That

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<v Speaker 1>added clarity helps doctor decide window start treatment before it

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<v Speaker 1>turns into something harder to reverse. You want more information

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<v Speaker 1>on that, give you a call. We can schedule that

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<v Speaker 1>for you. APPO lipoprotein B and now you know the

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<v Speaker 1>rest of the story have a great one. Folks, God

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<v Speaker 1>bless c Us.