Speaker 1: Afternoon, everybody, and welcome. It is June sixteenth. I've been
Speaker 1: off for a couple of days. I had the opportunity
Speaker 1: of my son and his wife come and stay with
Speaker 1: us for four or five days. It was wonderful, went
Speaker 1: to the beach, went to a concert, did a bunch
Speaker 1: of different things, and it was nice to reconnect. So
Speaker 1: I was out of it. I didn't do any podcasts
Speaker 1: during that time. I apologize, but we're going to get
Speaker 1: back to it now. A new article came out today
Speaker 1: talking about testing for cardiovascular disease problems, so we'll talk
Speaker 1: today about a new test that may help you in
Speaker 1: your battle with cardiovascar disease. Stay tuned, hi, and welcome
Speaker 1: to Health Talk with Doctor Lynn. Your daily dose. The
Speaker 1: information you hear on the show is informational. It's not
Speaker 1: meant to diagnose or treat any disease. Any kind of
Speaker 1: complete health conditions must be checked out and discussed with
Speaker 1: your primary care physician. Get ready for the good news
Speaker 1: of the day. God bless you, folks, and here is
Speaker 1: doctor Lynn. Our daily devotional today comes from the Book
Speaker 1: of Ephesians, Chapter two. Stay on the high road with me.
Speaker 1: Many voices clamor for your attention, trying to divert you
Speaker 1: to another path. But I've called you to walk over
Speaker 1: so closely with me, soaking in my presence, living in
Speaker 1: my peace. This is my unique design for you, planned
Speaker 1: before the world began. I have called each of my
Speaker 1: children to a different path, distinctly designed for that one.
Speaker 1: Do not let anyone convince you that his path is
Speaker 1: the only right way. Be careful not to extol your
Speaker 1: path as superior to another's way. What I require of
Speaker 1: you is to act justly, to love mercy, and to
Speaker 1: walk humbly with me wherever I lead.
Speaker 2: Stay tuned tin.
Speaker 3: Seven two seven nine one six four two one five
Speaker 3: to get a hold of me.
Speaker 1: Off air. Cholesterol testing, we all get it done almost
Speaker 1: on a regular basis. There's one test that very few
Speaker 1: of you really get. It's been a part of the
Speaker 1: Boston heart screening that I've been doing with patients now
Speaker 1: for the last twenty years, and it's now coming to
Speaker 1: the surface as one of the most widely recognized now
Speaker 1: and maybe a better test than just testing your total cholesterol.
Speaker 1: It's cap called apo lipoprotein B. Two people can have
Speaker 1: the same cholesterol level but very different heart disease risk.
Speaker 1: A simple test may explain why for some people a
Speaker 1: normal cholesterol reading doesn't always mean there's something to worry about.
Speaker 1: For about the price of a dinner out. A simple
Speaker 1: blood test can reveal a hidden layer of heart disease
Speaker 1: risk that standard cholesterol tests miss, Yet it isn't part
Speaker 1: of routine cholesterol screening, so most doctors don't order because
Speaker 1: they don't have a drug for it. The test measures
Speaker 1: apo lipoprotein B or APO B, a protein that sits
Speaker 1: on every particle that carries cholesterol through the bloodstream, sort
Speaker 1: of like a little truck. Unlike standard cholesterol tests, which
Speaker 1: measure how much cholesterol is circulating, ApoB counts the actual
Speaker 1: number of those harmful particles. Two people can have the
Speaker 1: same LDL or bad cholesterol level, but the one with
Speaker 1: more APO B containing particles are at our higher cardiovascular risk,
Speaker 1: said doctor Zang Zhang At, assistant professor at Columbia University.
Speaker 1: Standard cholesterol tests focus largely on LDL, the so called
Speaker 1: bad cholesterol, along with high density lipoprotein HDL. Higher levels
Speaker 1: of LDL and the blood are linked to an increased
Speaker 1: risk of heart attack and strokes, and for decades clinicians
Speaker 1: have used LDL L is their only and primary guide
Speaker 1: for treatment. Whoever, Heart disease risk is not about the
Speaker 1: amount of cholesterol present. It also depends on the number
Speaker 1: of cholesterol carriers. The number matters because these particles are
Speaker 1: not the same size. Smaller LDL particles can produce LDL readings,
Speaker 1: but a higher total number of harmful particles overall, a
Speaker 1: pattern associated with increased athoskerotic cardiovascar disease. An APPOB test
Speaker 1: closes that gap because each particle carries exactly one ApoB
Speaker 1: protein attached to it. Measuring ApoB gives you a direct
Speaker 1: count of how many harmful or atherogenic particles those capable
Speaker 1: burrowing into artery walls and depositing plaque, are circulating in
Speaker 1: the blood. When ApoB levels are higher than expected relative
Speaker 1: to your LDL levels, this mismatch is called discordance. Remember
Speaker 1: that name discordance. In these cases, low or normal cholesterol
Speaker 1: measures maydical reassuring, but they can give a false sense
Speaker 1: of security. More particles circulating the blood means more opportunities
Speaker 1: for them to contribute to plaque build up. Over time.
Speaker 1: These plaques eventually restrict blood flow and can lead to
Speaker 1: heart attacker strokes. Alternatively, having lower normal APPO B levels
Speaker 1: even in people with high LDL predicts a lower likelihood
Speaker 1: of plaque build up and a lower risk of athos choruses.
Speaker 1: So you can have a high LDL, have been a
Speaker 1: normal APPO B and not be at a cardiovascidar risk
Speaker 1: if you have a family history of early heart disease,
Speaker 1: of B CITY or other metabolic risk factors. Apo B
Speaker 1: may offer additional information beyond standard LDL cholesterol tests. Beyond
Speaker 1: helping to identify risks that might otherwise be missed, APPO
Speaker 1: B can also help doctors decide how aggressively to treat
Speaker 1: that risk. As a study published in JAMA, computer model
Speaker 1: stimulate simulating about two hundred and fifty thousand US adults
Speaker 1: eligible for statins compared three ways of guiding cholesterol lowering
Speaker 1: treatment by LDL cholesterol, by non HDL cholesterol, or ApoB.
Speaker 1: They found that by using APPO B to guide treatment
Speaker 1: decisions gave the greatest overall benefit. Let me read that again.
Speaker 1: They found that using APPO B to guide treatment decisions
Speaker 1: gave the greatest overall benefit. ApoB tests may be especially
Speaker 1: useful for assessing heart disease risk in younger adults. In
Speaker 1: another study published in JAMA Network, they followed ten thousand
Speaker 1: adults for roughly two decades. Drawing on data from three
Speaker 1: large US cohort studies. They examined how well different cholesterol
Speaker 1: markers predicted future heart attacks and strokes. Higher APPO B
Speaker 1: levels were associated with the greater heart disease risk and
Speaker 1: stroke across all age groups. However, the marker was especially
Speaker 1: informative in younger adults aged eight to thirty nine, with
Speaker 1: a risk gap between the high and low apo B
Speaker 1: levels was four times greater than in older adults. We
Speaker 1: found that APPO B may be more informative in younger adults.
Speaker 1: Adding APPO B to standard risk equations modestly improve the
Speaker 1: quality and the ability to identify which younger adults would
Speaker 1: go on to develop party of ascer disease. APPO B
Speaker 1: tests are relatively inexpensive, usually around sixty bucks through most
Speaker 1: major lab providers, but they are still not part of
Speaker 1: a routine cholesterol screening. One reason is practical, The test
Speaker 1: usually has to be ordered separately rather than included in
Speaker 1: a standard lipid panel, and doctors are lazy. It's also
Speaker 1: the question of habit. For decades, clinicians of a rite
Speaker 1: relied on LDL cholesterol assess risk and guide treatment, and
Speaker 1: shifting to a different approach can take time, even as
Speaker 1: evidence continues to build that may be starting to change.
Speaker 1: Current US guidelines still use the LDL cholesterol thresholds of
Speaker 1: less than one hundred for borderlined intermediate risk, less than
Speaker 1: seventy for high risk, less than fifty five for people
Speaker 1: with very high heart disease risk. However, health organizations, including
Speaker 1: the American Heart Association, increasingly emphasizing earlier diventions and new
Speaker 1: cardiovascular risk tools, are beginning to take a broader view
Speaker 1: of risk beyond LDL cholesterol alone. LDL and non HDL
Speaker 1: cholesterol still provide useful information, but APPOB is more directly
Speaker 1: tied to heart attack risk because it reflects the number
Speaker 1: of harmful cholesterol particles in the blood. For some people,
Speaker 1: especially those with diabetes, fatty liver disease, or obesity. That
Speaker 1: added clarity helps doctor decide window start treatment before it
Speaker 1: turns into something harder to reverse. You want more information
Speaker 1: on that, give you a call. We can schedule that
Speaker 1: for you. APPO lipoprotein B and now you know the
Speaker 1: rest of the story have a great one. Folks, God
Speaker 1: bless c Us.