Hidden
Heart Disease Risk

What is cardiovascular risk?

Cardiovascular risk is the likelihood of developing heart disease, having a heart attack or experiencing a stroke in the future. It is influenced by factors such as cholesterol levels, blood pressure, diabetes, smoking, family history and genetics.

How ApoB testing helps assess cardiovascular risk

Apolipoprotein B (ApoB) reflects the number of potentially harmful cholesterol-carrying particles, including LDL and related particles, that can enter and build up in artery walls. While a standard cholesterol test measures how much cholesterol is present, ApoB measures how many potentially harmful particles are circulating in the bloodstream.

Research suggests ApoB may better reflect the risk of heart disease and stroke than LDL cholesterol (LDL-C) alone, particularly when ApoB and LDL-C results do not align. As a result, two people with the same LDL ("bad") cholesterol result may have very different levels of cardiovascular risk.

What is Apolipoprotein A-I (ApoA-I)?

Apolipoprotein A-I (ApoA-I) is the main structural protein found in HDL ("good") particles. It plays a central role in reverse cholesterol transport, moving cholesterol from the peripheral tissues back to the liver for processing.

Lower ApoA-I levels may be associated with an increased risk of cardiovascular disease.

Together, ApoA-I and ApoB provide a more complete picture of cardiovascular health.

What is Lipoprotein(a), also known as Lp(a)?

Lp(a) is a specialised cholesterol particle that is largely determined by your genes.

Unlike many other cardiovascular risk factors, Lp(a) is not usually measured as part of a routine cholesterol test. Although lifestyle changes may not substantially reduce Lp(a), they remain important for lowering overall cardiovascular risk.

High Lp(a) levels have been linked to an increased risk of heart disease and stroke.

Because Lp(a) levels are largely genetically determined and generally remain stable throughout your lifetime, one measurement is generally sufficient for risk assessment.

Australia’s heart disease statistics

• Cardiovascular disease accounts for approximately 1 in every 4 deaths in Australia each year.¹
• Ischemic heart disease was the leading cause of death for Australian men in 2024, accounting for approximately 66% more deaths among men than women.²
• Approximately 1 in 5 people have elevated Lipoprotein(a), an inherited cardiovascular risk factor that is not routinely measured by standard cholesterol testing.³
• In 2023, there were an estimated 57,100 acute coronary events, including heart attacks, among Australians aged 25 years and over (around 156 every day).⁴
• In 2023, there were an estimated 41,100 stroke events in Australia (around 113 every day).⁵

Could apolipoprotein testing be right for you?

ApoB, ApoA-I and Lp(a) testing can provide information beyond a standard cholesterol test and may help identify hidden cardiovascular risk.

These tests may be particularly helpful if you:

• Have a family history of heart disease, particularly early heart attacks or strokes
• Have cholesterol results that do not fully explain your cardiovascular risk
• Want to better understand your balance of potentially "harmful" and "protective" cholesterol-carrying particles
• Want to know whether you have elevated Lp(a), an inherited cardiovascular risk factor that is not routinely measured
• Would benefit from additional information to help guide prevention and treatment decisions with your doctor

Where can I get tested?

Talk to your GP or cardiologist about whether ApoB, ApoA-I and Lp(a) testing may be right for you.

These blood tests are available at all Australian Clinical Labs collection centres with a doctor's referral.

Please note: There are currently no Medicare item numbers available for these tests. Current out-of-pocket pricing and payment information is available at: pay.clinicallabs.com.au. Australian Clinical Labs offers discounted pricing when ApoA-I and ApoB are requested together.

Visit our Locations Finder to locate your nearest Clinical Labs collection centre.