Cardiovascular risk blood test with ApoB and Lp(a)

First line

Cardiovascular risk blood test with ApoB, ApoA-I, lipoprotein(a), high-sensitivity CRP and a full cholesterol profile, plus TSH and kidney function. It looks at the number of atherogenic particles, identifies a raised Lp(a) of mainly genetic origin and adds context when LDL cholesterol alone does not explain risk well.

No prescription or appointment needed

Results in 3-5 working days

Blood and urine sample. Includes: Apolipoprotein B · Apolipoprotein A-I · Lipoprotein or Lp · High-sensitivity CRP · Lipid profile. 9 in total. See what each one measures

What it is for

It is used to extend a cardiovascular risk assessment when the conventional cholesterol profile falls short. ApoB answers how many particles capable of promoting atherosclerosis are circulating, while Lp(a) identifies a mainly inherited risk factor that can go unnoticed even when LDL is normal.

It is especially useful with a family history of early heart attack or stroke, persistently high cholesterol or an intermediate-risk situation. The result does not decide on its own whether treatment is required: it is interpreted together with age, blood pressure, smoking, diabetes and medical history.

When it is recommended

Raised LDL cholesterol or triglycerides in previous blood tests
Early heart attack, stroke or cardiovascular disease in first-degree relatives
Cardiovascular disease that seems out of proportion to conventional cholesterol
Diabetes, kidney disease or metabolic syndrome, situations in which LDL can underestimate the number of particles
Intermediate cardiovascular risk that calls for a more complete assessment
At least once in a lifetime, to know your lipoprotein(a)

Clinical comment

We have designed this profile around ApoB and Lp(a) because they answer questions that LDL does not always resolve. Two people with the same LDL cholesterol can have a different number of atherogenic particles, and ApoB helps identify that discordance.

Lp(a) depends largely on genetics and changes little with lifestyle. That is why the European guidelines advise measuring it at least once in adulthood. If it is raised, the result is built into the overall risk assessment; it does not mean that a cardiovascular event will happen and should not be interpreted in isolation.

High-sensitivity CRP has a more limited role. It can add information in selected situations, but it rises with infections, injuries and many other kinds of inflammation. Bear in mind that a high result during an acute illness does not allow cardiovascular risk to be assessed properly and usually means repeating the test once the person has recovered.

TSH and kidney function complete the assessment because hypothyroidism or kidney disease can change cholesterol and risk. We have not included routine particle size by Liposcale®, since ApoB usually provides the most clinically useful information with a simpler test.

Dr. Antonio Mas

What is tested

Apolipoprotein B (ApoB): Estimates the number of atherogenic particles, that is, those that can deposit cholesterol in the artery wall.
Apolipoprotein A-I (ApoA-I): The main protein in HDL particles, used to calculate the ApoB/ApoA-I ratio.
Lipoprotein(a) or Lp(a): A particle determined mainly by genetics. A high concentration is associated with greater cardiovascular risk, and measuring it once in a lifetime is usually enough.
High-sensitivity CRP: Measures low-grade inflammation and can act as a risk modifier in selected cases. It is not specific to the heart or the arteries.
Lipid profile (total cholesterol, HDL, LDL, triglycerides)
Non-HDL cholesterol and TC/HDL, LDL/HDL and ApoB/ApoA-I ratios: Relate the different fractions to each other and complete the reading of the lipid profile.
TSH: Helps assess whether there is hypothyroidism, a cause that can raise cholesterol.
Creatinine and eGFR: Assess kidney function, which influences cardiovascular risk and later decisions.
Urine albumin/creatinine ratio: Detects small losses of albumin and gives information about kidney and vascular damage.

How to prepare

Fast for 8 to 12 hours. You can drink water. Bring a sample of your first morning urine or collect it at the partner centre. If you have recently had a fever, an infection or inflammation, wait until you have recovered before measuring high-sensitivity CRP, because the result could reflect that process rather than your baseline cardiovascular risk.

You can add

Without another needle. It is offered when you order, so you do not have to decide now.

General blood testA general blood test with full blood count, glucose, cholesterol and kidney and liver function: the basic parameters included in any general check-up.+€59.00
General + nutritional blood testEverything in the general blood test (anaemia, kidneys, liver, cholesterol and glucose) plus iron stores, vitamin D, vitamin B12 and folic acid. It is the broadest add-on: it covers the general and the nutritional in one go.+€129.00
Cholesterol particle size (Liposcale®)Analyses the size and number of the particles that carry cholesterol, information a standard blood test does not provide and that allows a better assessment of cardiovascular risk.+€123.00
Sugar, insulin and inflammationAssesses insulin resistance through fasting insulin and the HOMA-IR index, plus average blood sugar over the last three months and low-grade inflammation.+€59.00

Related blood tests

We have other profiles in Heart and diabetes with more or fewer tests:

The most comprehensive is not always the most useful. This is the one we recommend to start with; the others cover specific situations.

What it is based on

Mach F, Baigent C, Catapano AL, et al. · European Heart Journal 41(1):111-188
2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk
Recommends measuring ApoB to assess risk in people with high triglycerides, diabetes, obesity or very low LDL cholesterol, because in those situations LDL underestimates the number of particles that carry cholesterol.
Kronenberg F, Mora S, Stroes ESG, et al. · European Heart Journal 43(39):3925-3946
Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement
Recommends measuring Lp(a) at least once in adult life. More than 90% of its concentration is determined by genetics and it hardly changes afterwards, which is why measuring it once is enough.

Protocol designed by Dr. Antonio Mas, specialist in Endocrinology and Nutrition, Spanish medical licence no. 080846289, and reviewed in September 2026.

This blood test is a standardised protocol and does not replace a medical consultation. If you have symptoms, a known condition or a complex clinical situation, speak to your doctor.