Enhanced Cholesterol Blood Test

A standard cholesterol test measures how much cholesterol is in your blood and how it is divided between HDL and LDL. An advanced lipid profile measures the particles that carry it and the inherited and inflammatory factors a standard test cannot see. ApoB counts the number of artery-damaging particles; lipoprotein(a) identifies an inherited risk that does not respond to diet; ApoA1 measures the protective particles; PLAC activity measures inflammation inside the artery wall. These markers find risk that a standard cholesterol test cannot see.

Every particle that can deposit cholesterol in an artery wall, LDL, VLDL, IDL and lipoprotein(a), carries exactly one apolipoprotein B molecule. Measuring ApoB therefore counts the particles rather than the cholesterol inside them, and it is the number of particles that determines how much gets into the artery wall. Two people with the same LDL can have very different ApoB: the one with many small, cholesterol-poor particles is at higher risk, and only ApoB shows it. Major guidelines now recommend ApoB as a better predictor of heart attack and stroke than LDL, particularly in people with diabetes, obesity or high triglycerides. An ApoB below about 0.8 g/L is desirable; below 0.65 for people at high risk.

Lipoprotein(a) is an LDL particle with an extra protein attached that makes it stickier and more inflammatory. Your level is set almost entirely by your genes, changes little through life, and is not lowered by diet, exercise or statins. Around one in five people has a level high enough to roughly double their risk of heart attack, stroke and aortic valve disease, usually without knowing. Because it does not change, it only needs measuring once, and guidelines now recommend that every adult has it measured at least once, especially with a family history of early heart disease. A high result changes how aggressively other risk factors are treated.

PLAC measures the activity of lipoprotein-associated phospholipase A2, an enzyme carried on LDL particles that becomes active inside artery walls and drives the inflammation that makes plaques unstable and liable to rupture. It is a marker of vascular inflammation specifically, unlike CRP, which rises with any inflammation in the body. A raised PLAC result alongside raised ApoB or lipoprotein(a) identifies the people whose plaques are most likely to cause a heart attack or stroke.

Anyone with a parent or sibling who had a heart attack or stroke before 60; anyone whose standard cholesterol was normal but who has a strong family history or has been told they have arterial plaque; people with diabetes, obesity or high triglycerides, in whom LDL underestimates risk; people already on a statin who want to know whether their particle count is controlled; and anyone who wants the most complete cardiovascular risk assessment once, to plan from. For a first check without those factors, our Cardiac Risk test (from £59) is the sensible start.

Not routinely. NHS lipid testing covers total, HDL, non-HDL and triglycerides; ApoB is sometimes measured in lipid clinics, and lipoprotein(a) is recommended by the guidelines but only tested when a specialist requests it, typically after a premature heart attack or with a strong family history. A private test gives you the full profile now, and the GP report can be shared with your GP, who may refer you to a lipid clinic if lipoprotein(a) or ApoB is high.

Yes, 8 to 12 hours with nothing but water, so book a morning appointment. Fasting keeps triglycerides and the calculated markers comparable with the reference ranges. Take your usual medication, including statins, and eat normally the evening before rather than unusually well, so the result reflects your typical diet.

Our Enhanced Cholesterol Blood Test is £189 at one of 250+ Goodbody clinics or £209 with a nurse home visit, including the blood draw, all eleven markers and a GP report. Advanced lipid panels with lipoprotein(a) and ApoB in the UK typically cost £150 to £300, and lipoprotein(a) alone is often £60 to £90; here it is part of the panel.

Your GP report explains what the result means for your overall risk and what to do. High lipoprotein(a) cannot be lowered by lifestyle, so the response is to treat everything else more aggressively: lower LDL and ApoB targets, usually with a statin, tight blood pressure control, not smoking, and consideration of aspirin or newer treatments through a lipid clinic; first-degree relatives should be tested too. High ApoB responds to the same measures as LDL, with statins and, where needed, additional drugs. Take the report to your GP for referral.

The Cholesterol Blood Test (from £49) measures the six standard lipid markers. The Cardiac Risk test (from £59) adds HbA1c and high-sensitivity CRP for diabetes and general inflammation. This Enhanced Cholesterol Blood Test (£189) adds the particle and genetic markers, ApoB, ApoA1, lipoprotein(a) and PLAC, that reveal risk the other two cannot. If you want everything, the Signature Well Man and Well Woman tests include all of these markers within a 66-marker panel.

Results are emailed within 3 to 5 working days of your sample reaching the laboratory, with a GP report that interprets the eleven markers together and sets out what, if anything, to do next.

At any of 250+ Goodbody clinics across the UK, with morning appointments for fasting tests, or with a nurse visiting your home. The test needs a venous sample and is not available as a finger-prick kit. No GP referral is needed. Find your nearest clinic.