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Apolipoprotein B

ApoB

LDL cholesterol is the most commonly cited cardiovascular risk marker — and one of the least accurate. Why ApoB is a superior measure of atherogenic risk, how discordance works, and what your target should be.

Also written as apo B, apolipoprotein B-100.

What should my ApoB be?

Enter your result to see which clinical range it falls into.

ApoB interpreter
100
90 mg/dLAt target

At or below the < 100 mg/dL target for general primary prevention.

Targets by risk category from the article (EAS; AHA/ACC 2018). Some preventive cardiologists target < 60–70 mg/dL for optimal metabolic health. Lab “normal” (~50–120) is population-based, not optimal. Estimate for education only — not a diagnosis. Interpret lab results with your clinician.

ApoB ranges, and what each one means

These are the same thresholds the interpreter above uses.

Primary prevention

Range Category What it means
< 100 mg/dL At target At or below the < 100 mg/dL target for general primary prevention.
≥ 100 mg/dL Above target Above the < 100 mg/dL primary-prevention target. Atherogenic particle number drives risk, so lower is better — worth a conversation about lowering ApoB (diet, then statin/ezetimibe if needed).

High risk

Range Category What it means
< 80 mg/dL At target At or below the < 80 mg/dL target for high-risk patients (diabetes, 10-year CVD risk ≥ 10%, or multiple risk factors).
≥ 80 mg/dL Above target Above the < 80 mg/dL high-risk target. Discuss intensifying lipid-lowering therapy with your clinician to reduce particle burden.

Very high risk

Range Category What it means
< 70 mg/dL At target At or below the < 70 mg/dL target for very-high-risk patients (established ASCVD, or ASCVD plus diabetes, CKD, or familial hypercholesterolemia).
≥ 70 mg/dL Above target Above the < 70 mg/dL very-high-risk target. This group benefits most from aggressive particle reduction — a clinician conversation is warranted.

Where these come from: Targets by risk category from the article (EAS; AHA/ACC 2018). Some preventive cardiologists target < 60–70 mg/dL for optimal metabolic health. Lab “normal” (~50–120) is population-based, not optimal.

Estimate for education only — not a diagnosis. Interpret lab results with your clinician.

The short version

  • ApoB counts the total number of atherogenic lipoprotein particles in your blood — LDL, VLDL, IDL, and Lp(a) — each of which carries exactly one ApoB molecule.
  • LDL-C measures cholesterol content, not particle number. Two people with identical LDL-C can have dramatically different cardiovascular risk depending on particle count.
  • Discordance between LDL-C and ApoB is common in people with insulin resistance, metabolic syndrome, or low total cholesterol — and it's the group most likely to be falsely reassured by standard testing.
  • Most cardiovascular guidelines now recognize ApoB as a superior risk marker and recommend it for risk stratification in intermediate-risk patients.
  • Target ApoB levels: <100 mg/dL for primary prevention, <80 mg/dL for high-risk patients, <70 mg/dL for very high-risk or established ASCVD.

The full guide

What Is ApoB and Why It Matters More Than LDL

12 min read · Sean Moshrefi, PharmD, MS

Read →

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