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A cardiologist says total cholesterol doesn’t reveal true heart disease risk—and points to six lipid markers that offer a clearer, more accurate picture of cardiovascular health.
If you’ve ever scanned your blood test and zeroed in on total cholesterol, cardiologists say you may be missing the numbers that actually signal heart risk. New guidance shared by US-based cardiologist Dmitry Yaranov explains why a deeper read of your lipid panel matters far more than a single headline figure.
In an Instagram video posted on 12 February, Dr Yaranov—who specialises in advanced heart failure and heart transplants—made the point clearly: “Most people focus on total cholesterol. That’s not the number that matters. Here’s what you should actually know about your lipid panel.”
Heart disease risk is driven by specific cholesterol-carrying particles that directly fuel plaque build-up in arteries. Knowing these markers can help patients and doctors make more precise prevention decisions—sometimes even when total cholesterol appears “normal”.
Here are the six lipid markers he says deserve attention:
- LDL-C (Low-density lipoprotein cholesterol)
Often called “bad” cholesterol, LDL-C carries cholesterol through the bloodstream. When levels rise, cholesterol can deposit in artery walls. As Dr Yaranov puts it, “LDL-C drives plaque. Lowering LDL reduces cardiovascular risk. This is causal.”
- ApoB (Apolipoprotein B)
ApoB reflects the total number of plaque-forming particles in the blood, including LDL and other harmful lipoproteins. According to the cardiologist, it is a stronger predictor of heart disease than LDL alone. “ApoB counts the number of atherogenic particles (LDL, VLDL, IDL, Lp(a)). More ApoB equals more plaque-driving particles. If LDL and ApoB disagree, ApoB wins.”
- Non-HDL cholesterol
As explained by the Cleveland Clinic, non-HDL cholesterol includes all cholesterol types linked to artery plaque. Dr Yaranov notes it can act as a useful substitute when ApoB testing is unavailable. “Non-HDL is a practical backup for ApoB if it’s not measured.”
- Triglycerides
Triglycerides are fats that provide energy, but high levels may indicate excess harmful particles in circulation. The cardiologist advises further testing when these are elevated: “High levels often signal excess atherogenic particles. If elevated, check ApoB.”
- Lp(a) [Lipoprotein(a)]
According to the American Heart Association, Lp(a) is a genetically inherited cholesterol particle that independently raises the risk of heart disease and stroke. Dr Yaranov highlights how common—and often overlooked—it is. “Lp(a) is genetically inherited. Approximately 20 percent of people have elevated levels. Increases risk even if LDL looks ‘normal.’ Measure it at least once in your lifetime.”
- HDL (High-density lipoprotein)
HDL helps transport cholesterol away from arteries, a function outlined by the Mayo Clinic. But high HDL is not a safety shield. As the cardiologist cautions, “Raising HDL does not reduce cardiovascular events. High HDL does not cancel high LDL.”
The prevention takeaway
Dr Yaranov distils modern heart disease prevention into a simple rule: “lower ApoB, lower LDL, and know your Lp(a).” For readers, this means asking better questions during routine check-ups and understanding that heart risk is about particle burden—not just total cholesterol.
(Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. It is based on user-generated content from social media. Mint has not independently verified the claims and does not endorse them.)
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