Atherosclerosis is the silent architect of heart disease. It builds up over decades without symptoms, and by the time issues arise, significant damage is already done. But here's the good news: you don't have to wait for symptoms. Testing your ApoB and Lp(a) levels gives you the clearest picture of your cardiovascular risk—long before problems occur.

Most doctors don't routinely check these markers, and traditional cholesterol tests are insufficient when it comes to predicting heart disease risk. If you're serious about preventing heart attacks and strokes, you need to be proactive in requesting these tests.

ApoB: The Best Predictor of Atherosclerosis

Apolipoprotein B (ApoB) is the single most accurate marker for measuring the number of lipoproteins that contribute to plaque buildup in your arteries. Each LDL particle contains one ApoB molecule, meaning that measuring ApoB tells you exactly how many LDL particles you have in circulation.

• Why standard cholesterol tests fail: LDL-C (the "bad cholesterol" most doctors measure) only tells you how much cholesterol is in these particles, not how many particles exist. Someone with normal LDL-C can still have dangerously high ApoB levels due to an excessive number of small, dense LDL particles.
• Scientific consensus: Numerous studies have confirmed that ApoB is a stronger predictor of heart disease than LDL or total cholesterol. If your goal is to prevent cardiovascular disease, this is the number that matters most.

The higher your ApoB, the more particles are in circulation, and the more likely they are to cause arterial blockages. Lowering ApoB reduces your risk of heart disease—regardless of what your standard cholesterol test says.

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Most Doctors Don’t Order These Tests—Here’s Why You Should

Even though ApoB and Lp(a) are superior markers for assessing heart disease risk, they are not part of standard cholesterol panels. Many doctors still rely on outdated testing methods and guidelines, leaving patients unaware of their true cardiovascular risk.

If your doctor hasn’t recommended testing for ApoB and Lp(a), you need to advocate for yourself. Ask for these tests, or consider working with a preventative medicine or longevity-focused healthcare provider who understands their importance.

Atherosclerosis Starts Early—Don’t Wait for Symptoms

Heart disease doesn’t develop overnight. Plaque starts forming in your arteries in your 20s or 30s, and by the time you’re in your 50s or 60s, a heart attack can feel like it came out of nowhere.

Understanding your true cardiovascular risk early allows you to take proactive steps—whether through diet, exercise, targeted supplementation, or medication—to prevent problems before they happen.

How to Get Tested & What to Do Next

If you’re serious about prevention and longevity, get tested for ApoB and Lp(a) as part of your routine health screening.

✅ How to get tested: If your doctor won’t order them, consider using a direct-to-consumer lab or working with a concierge medicine provider focused on heart disease prevention.

If Your ApoB is High:

• Prioritize a low-inflammatory diet rich in fiber, omega-3 fatty acids, and polyphenols.
• Consider medications like statins, ezetimibe, or PCSK9 inhibitors if recommended by your doctor.
• Strength train and engage in cardiovascular exercise to improve lipid metabolism.

If Your Lp(a) is High:

• Work with your doctor to develop a personalized cardiovascular prevention plan.
• Focus on lowering ApoB and reducing all other modifiable risk factors (such as inflammation and blood pressure).
• Keep an eye on emerging therapies, as new treatments targeting Lp(a) are currently in clinical trials.

Longevity is About Preventing the Big Killers—And Atherosclerosis is #1

At SageHealth, we believe that the best longevity strategy isn’t about chasing the latest biohacking trend—it’s about preventing the things that kill most people from killing you. And the #1 cause of death worldwide is cardiovascular disease, largely driven by atherosclerosis.

The Numbers Don’t Lie:

🔹 Cardiovascular disease is the leading cause of death globally, responsible for nearly 18 million deaths per year—that’s one-third of all deaths. WHO Data
🔹 In the U.S., 1 in every 4 deaths is due to heart disease. CDC
🔹 Over 50% of people who have a heart attack had “normal” cholesterol levels—because standard cholesterol tests don’t measure the actual drivers of atherosclerosis like ApoB and Lp(a). (JAMA Study))
🔹 Atherosclerosis begins decades before symptoms appear—studies show fatty streaks in arteries of teenagers and young adults, long before traditional risk factors would flag them as “at risk.” PDAY Study

The tragedy? Most of these deaths are preventable—but only if you catch the warning signs early enough to act.

What We Get Wrong About Heart Disease

Many people assume that heart disease is inevitable or only a concern for the elderly. In reality, it’s a lifelong process that starts early and accelerates without intervention. By the time most people realize they have a problem, it's too late.

The standard approach to heart disease is reactive, waiting until someone has a heart attack or significant arterial blockages before treating the problem. But longevity isn’t about waiting for disease—it’s about preventing it.

• ApoB and Lp(a) are the most powerful predictors of heart disease. If your doctor isn’t testing for them, you’re missing the most important information about your cardiovascular risk.
• Atherosclerosis doesn’t care about “normal” cholesterol. If your ApoB is high, you’re at risk—regardless of what your LDL cholesterol says.

Heart disease is largely preventable. With the right data, you can lower your risk by 80%—but only if you identify the problem early enough.

The SageHealth Longevity Strategy: Prevention Over Treatment

Our philosophy is simple: stop the big killers before they start. That means focusing on the biggest causes of premature death—cardiovascular disease, metabolic dysfunction, and neurodegeneration—by identifying silent risks before they become full-blown disease states.

🚀 Step 1: Identify Risk Early → Get tested for ApoB, Lp(a), insulin resistance, and inflammation markers.
🏋️ Step 2: Take Action → Optimize diet, exercise, supplements, and medication (if necessary) to reduce risk.
🔄 Step 3: Track Progress → Retest and adjust your strategy as needed to ensure you stay ahead of disease.

At SageHealth, we don’t just believe in extending lifespan—we believe in extending healthspan by preventing the biggest threats to longevity. ApoB and Lp(a) testing give you the data you need to make smarter decisions and take control of your future.

💡 The best time to prevent heart disease was 20 years ago. The second best time is today. Get tested. Take control. Live longer.