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1Repair Windows errors before they cause bigger problems2Scan for outdated or missing drivers - takes under a minute3Clear out junk files and repair common Windows errorsA standard lipid panel is the starting point for blood-test assessment of cardiovascular risk. Depending on your health and existing results, a clinician may also consider high-sensitivity C-reactive protein (hs-CRP), lipoprotein(a) [Lp(a)], or apolipoprotein B (ApoB). These tests measure different things: cholesterol, atherogenic particles, or inflammation. None diagnoses heart disease by itself.
Which blood tests are used?
| Test | What it measures | How it may inform risk assessment |
|---|---|---|
| Lipid panel | Total cholesterol, LDL-C, HDL-C, and triglycerides | Routine starting point for estimating atherosclerotic cardiovascular disease (ASCVD) risk. |
| hs-CRP | Low levels of C-reactive protein, a marker of inflammation | May add information to a risk discussion in selected settings; it is not specific to inflammation in the cardiovascular system. |
| Lp(a) | An LDL-like, cholesterol-carrying particle whose level is largely inherited | Can identify an inherited risk factor associated with heart attack, stroke, and aortic stenosis. The CDC notes that it is ordered as a separate test: CDC: About Lipoprotein (a). |
| ApoB | A measure reflecting atherogenic lipoprotein particles | Can clarify risk or treatment decisions for selected people, including some with high triglycerides, diabetes, or cardio-kidney-metabolic risk. |
Start with a standard lipid panel
A lipid panel measures total cholesterol, LDL-C, HDL-C, and triglycerides. These values provide a foundation for estimating cardiovascular risk, but they are interpreted alongside other risk factors rather than used as a standalone diagnosis. The American Heart Association explains how to get your cholesterol tested.
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Fasting is not always necessary: the 2018 ACC/AHA cholesterol guideline says fasting or nonfasting lipid profiles are effective for estimating ASCVD risk in adults who are not taking lipid-lowering therapy. Follow the ordering clinician’s instructions for your own test. See the 2018 ACC/AHA cholesterol guideline.
When hs-CRP may help
hs-CRP detects low-level C-reactive protein, a marker of inflammation. The AHA describes it as a sign of inflammation linked to increased heart attack or stroke risk. A result can contribute to a clinician’s assessment, but it does not identify the cause or location of inflammation and cannot establish that someone has cardiovascular disease. The ACC/AHA cardiovascular risk assessment evidence review provides context for using risk markers.
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In the 2019 ACC/AHA primary prevention framework, hs-CRP of at least 2.0 mg/L was listed as a risk-enhancing factor. This is historical guideline context, not a diagnosis or a complete current treatment rule. The 2019 ACC/AHA primary prevention guideline executive summary describes that framework.
Why ask about Lp(a) at least once?
Lp(a) levels are largely inherited, and the test is separate from a standard lipid panel. The 2026 ACC/AHA dyslipidemia guideline recommends measuring Lp(a) at least once in all adults for ASCVD risk assessment. Elevated Lp(a) is associated with heart attack, stroke, and aortic stenosis.
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The 2019 ACC/AHA primary prevention framework listed Lp(a) of at least 50 mg/dL or 125 nmol/L as a risk-enhancing factor. Those are two reported-unit thresholds; do not assume a single universal conversion between them or treat either as a diagnosis. The 2026 guideline supersedes the 2018 cholesterol guideline and recommends at-least-once adult testing; see the 2026 AHA/ACC dyslipidemia guideline summary and the 2026 ACC/AHA dyslipidemia guideline.
When ApoB can add information
ApoB reflects atherogenic lipoprotein particles and may reveal detail that cholesterol values alone do not capture. It can be useful for selected people, including some with high triglycerides, diabetes, or cardio-kidney-metabolic risk, when a clinician is refining risk or deciding whether additional lipid treatment is appropriate. It is not necessarily needed for everyone.
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ApoB of at least 130 mg/dL was listed as a risk-enhancing factor in the 2019 ACC/AHA primary prevention framework. Use that figure as historical context, not as a universal current treatment threshold; the 2026 dyslipidemia guideline recommends selective ApoB measurement. The guideline summary lists key points on the 2026 dyslipidemia guideline.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.How clinicians put results in context
Blood-test results are one part of risk assessment. The 2026 dyslipidemia guideline highlights PREVENT-ASCVD equations and coronary artery calcium imaging in selected cases to refine risk. A clinician can consider your overall profile and whether a biomarker result would change the prevention or treatment discussion. The AHA’s overview of cholesterol guideline recommendations explains the role of cholesterol assessment.
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For practical questions, ask which result a test is intended to clarify, whether it is already included in your lipid panel, and how the result might affect your care. In particular, Lp(a) is ordered separately; hs-CRP and ApoB are additional tests rather than substitutes for a complete risk assessment.
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