# ApoA-1: The main protein on your HDL particles

> ApoA-1 is the main protein on HDL. See what a low level means for men and women, how the ApoB/ApoA-1 ratio works, and why there’s no target.

- Also called Apolipoprotein A-1, Apolipoprotein A-I and Apo A1
- Not on a standard checkup
- No fasting needed
- Web page: https://picardo.health/guides/biomarkers/apoa1

## The short answer

ApoA-1 is the main protein on HDL particles, so it gives a rough count of them. Below the lab’s range, under 101 mg/dL for men or 116 for women, it goes with higher heart risk.[2][8] But raising it hasn’t been shown to prevent heart attacks.[6]

- **A good result:** Within the lab’s range, which is 101 to 178 mg/dL for men and 116 to 209 for women.[8] Above that isn’t extra protection.[5]
- **If yours is low:** It usually means your HDL is low too, a sign of higher heart risk. Check ApoB, which counts the particles that build plaque.[1][7]
- **Should you test?** It adds most next to ApoB, as the ApoB/ApoA-1 ratio.[3] A ratio from a standard cholesterol test predicts about as well, though.[4]

## What is a normal ApoA-1 level?

Labcorp’s range is higher for women than for men. A result below it is the one that matters, and even then it’s a sign to look at the rest of your heart risk rather than something to treat:[7][8]

Which applies to you?

### Man

| Result (mg/dL) | What it means |
| --- | --- |
| Under 101 | Below the lab’s range |
| 101 to 178 | Within the lab’s range |
| 179 or more | Above the lab’s range |

### Woman

| Result (mg/dL) | What it means |
| --- | --- |
| Under 116 | Below the lab’s range |
| 116 to 209 | Within the lab’s range |
| 210 or more | Above the lab’s range |

### Below the lab’s range

**Range:** Under 101 mg/dL for men; under 116 for women.

Low ApoA-1 goes with a higher risk of heart attack.[2] It usually comes with low HDL cholesterol, which mostly reflects high triglycerides and the particles that carry them.[1]

**How worried to be:** Not urgent. It’s a reason to look at your other numbers, not one to treat.

**What to do next:**

1. Check ApoB. It counts the particles that build plaque, and US guidelines use it to fine-tune treatment once LDL goals are met.[7]
2. Look at triglycerides and blood sugar. High triglycerides and insulin resistance often come with low HDL.[7]
3. Skip supplements or medicines meant to raise it. In trials, raising ApoA-1 didn’t prevent heart attacks.[6]

[Test ApoB, a lipid panel and HbA1c, $16.90](https://app.picardo.health/labs/order?tests=167015,303756,001453&ref=guide-apoa1)

### Within the lab’s range

**Range:** 101 to 178 mg/dL for men; 116 to 209 for women.

Your ApoA-1 is typical for an adult. It doesn’t offset other risks: treatment decisions rest on LDL cholesterol, non-HDL cholesterol and ApoB, along with blood pressure, blood sugar and smoking.[7]

**How worried to be:** Nothing to worry about.

**What to do next:**

1. If you haven’t, check ApoB. With both numbers, you can work out your ApoB/ApoA-1 ratio, explained below.
2. Check Lp(a) once if you never have. It’s inherited, and US guidelines recommend measuring it in every adult.[7]

[Test ApoB and Lp(a), $24.40](https://app.picardo.health/labs/order?tests=167015,120188&ref=guide-apoa1)

### Above the lab’s range

**Range:** Over 178 mg/dL for men; over 209 for women.

Your lab will flag this as high. It usually comes with high HDL cholesterol.[1] It isn’t extra protection: people whose genes give them more ApoA-1 don’t have fewer heart attacks.[5]

**How worried to be:** Not a worry on its own.

**What to do next:**

1. Judge your heart risk on ApoB or LDL cholesterol, blood pressure, blood sugar and smoking.[7]
2. If your HDL cholesterol is very high too, read the HDL guide.

[Test ApoB and Lp(a), $24.40](https://app.picardo.health/labs/order?tests=167015,120188&ref=guide-apoa1)

## What is ApoA-1?

> If ApoB counts the trucks carrying cholesterol into your artery walls, ApoA-1 roughly counts the ones that can carry it back out. Roughly, because each HDL particle has two or three copies, not one.[1]

It’s the protein that holds HDL particles together and helps them pull spare cholesterol out of cells.[1] The lab measures the protein itself, not the cholesterol HDL carries.

## How is ApoA-1 different from ApoB?

They sit on opposite sides of the ledger. ApoB is on every particle that builds plaque, one per particle, so it’s an exact count of them.[7] ApoA-1 is on HDL, and a higher level goes with lower risk.[2]

Only one of them is something to treat. Lowering ApoB is a goal of treatment; raising ApoA-1 isn’t.[6][7]

|  | ApoA-1 | ApoB |
| --- | --- | --- |
| Found on | HDL particles | LDL, VLDL and Lp(a) particles |
| Copies on each particle | Usually two or three[1] | Exactly one[7] |
| A higher level means | Lower risk, on average[2] | Higher risk[2] |
| Used to guide treatment | No | Yes, once LDL goals are met[7] |

## What is the ApoB/ApoA-1 ratio?

Divide your ApoB by your ApoA-1. The higher the result, the more plaque-building particles you have compared with HDL. Two large studies made the case for it:

- AMORIS followed about 175,000 people for around five years. A higher ratio strongly predicted death from a heart attack, in men and in women.[2]
- INTERHEART compared about 9,300 people who’d had a heart attack with 12,100 who hadn’t, across 52 countries. The ratio was more closely tied to heart attacks than any cholesterol ratio, in every ethnic group and at every age.[3]

A pooled analysis of 68 studies found less of an edge. There, the ApoB/ApoA-1 ratio predicted heart disease no better than non-HDL divided by HDL cholesterol, which you can work out from a standard test.[4]

## Should you try to raise ApoA-1?

No. Raising it hasn’t been shown to lower heart risk:

- In AEGIS-II, 18,219 people who’d just had a heart attack got four weekly infusions of ApoA-1 or a placebo. After 90 days, 4.8% of the ApoA-1 group and 5.2% of the placebo group had had another heart attack, a stroke or a death from heart disease. A gap that small could be chance.[6]
- People born with gene variants that raise ApoA-1 and HDL don’t have fewer heart attacks.[5]
- Across studies, ApoA-1’s link to heart risk is no stronger than HDL cholesterol’s.[1]

The steps that lower heart risk act on ApoB instead. The [ApoB guide](https://picardo.health/guides/biomarkers/apob.md) covers them.

## Who should get an ApoA-1 test?

It adds the most if:

- You’re testing ApoB and want the ratio.[2][3]
- Your HDL is very low and a specialist is looking for an inherited cause. Rare changes in the APOA1 gene are one.[1]

For decisions about treatment, LDL cholesterol, non-HDL cholesterol and ApoB matter more.[7]

## How to get an ApoA-1 test, and what it costs

An ApoA-1 test costs $8.25 through Picardo. The Heart Health panel adds 16 more tests from the same visit for $150.90.

- **Recommended:** [the Heart Health panel, $150.90](https://app.picardo.health/labs/order?panels=heart-health&ref=guide-apoa1). 17 tests, fast for 12 hours first. The panel measures ApoA-1 and ApoB from the same draw, so you get the ratio. It adds Lp(a), an advanced cholesterol profile, and HbA1c and insulin for blood sugar. [What’s in it](https://picardo.health/guides/panels/heart-health.md).
- [ApoA-1 on its own, $8.25](https://app.picardo.health/labs/order?tests=016873&ref=guide-apoa1). Labcorp 016873, no fasting needed.

Every order comes with:

- Results in 2 to 3 days, in the app
- Physician follow-up if you want one
- Free Labcorp draw, or $75 at home
- No other fees. HSA and FSA eligible.

Already have a result? [Ask Picardo about it](https://app.picardo.health/auth).

## Questions people ask

### Do I need to fast for an ApoA-1 test?

No. Apolipoproteins predict heart risk just as well in blood taken after a meal.[3][4] If other tests in the same draw need fasting, such as insulin, fast for those.

### Is ApoA-1 the same as HDL cholesterol?

Not quite. HDL cholesterol measures the cholesterol inside HDL particles, while ApoA-1 measures their main protein. The two usually move together, and ApoA-1 predicts heart risk no better than HDL cholesterol does.[1][5]

### Is ApoA-1 on a standard cholesterol test?

No. A standard test measures total cholesterol, HDL cholesterol and triglycerides, and estimates LDL.[7] ApoA-1 has to be ordered on its own or as part of a panel.

### What is a good ApoB/ApoA-1 ratio?

There isn’t an agreed cutoff, and the US cholesterol guideline doesn’t use the ratio.[7] In the studies behind it, the lower the ratio, the lower the risk of a heart attack.[2][3]

## Often checked alongside

- [HDL cholesterol](https://picardo.health/guides/biomarkers/hdl-cholesterol.md): Cholesterol carried away from your arteries
- [ApoB](https://picardo.health/guides/biomarkers/apob.md): How many plaque-building particles you have
- [Lp(a)](https://picardo.health/guides/biomarkers/lipoprotein-a.md): An inherited particle that raises heart risk
- [Triglycerides](https://picardo.health/guides/biomarkers/triglycerides.md): Blood fats that rise with sugar and alcohol

## Test details

- **Labcorp test:** Apolipoprotein A-1, 016873
- **LOINC:** 1869-7
- **Sample:** Blood
- **Fasting:** Not needed[4]
- **Typical lab range:** 101 to 178 mg/dL (men), 116 to 209 mg/dL (women; 114 to 214 over 80)[8]
- **Units:** mg/dL in the US. For g/L, divide by 100.

## Sources

1. von Eckardstein A, Nordestgaard BG, Remaley AT, Catapano AL. High-density lipoprotein revisited: biological functions and clinical relevance. Eur Heart J. 2023;44(16):1394–1407. https://doi.org/10.1093/eurheartj/ehac605
2. Walldius G, Jungner I, Holme I, et al. High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study. Lancet. 2001;358(9298):2026–2033. https://doi.org/10.1016/S0140-6736(01)07098-2
3. McQueen MJ, Hawken S, Wang X, et al. Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-control study. Lancet. 2008;372(9634):224–233. https://doi.org/10.1016/S0140-6736(08)61076-4
4. Emerging Risk Factors Collaboration; Di Angelantonio E, Sarwar N, Perry P, et al. Major lipids, apolipoproteins, and risk of vascular disease. JAMA. 2009;302(18):1993–2000. https://doi.org/10.1001/jama.2009.1619
5. Haase CL, Tybjærg-Hansen A, Grande P, Frikke-Schmidt R. Genetically elevated apolipoprotein A-I, high-density lipoprotein cholesterol levels, and risk of ischemic heart disease. J Clin Endocrinol Metab. 2010;95(12):E500–E510. https://doi.org/10.1210/jc.2010-0450
6. Gibson CM, Duffy D, Korjian S, et al. Apolipoprotein A1 infusions and cardiovascular outcomes after acute myocardial infarction. N Engl J Med. 2024;390(17):1560–1571. https://doi.org/10.1056/NEJMoa2400969
7. Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of dyslipidemia. Circulation. 2026;153(17):e1154–e1276. https://doi.org/10.1161/CIR.0000000000001423
8. Labcorp. Apolipoprotein A-1 (test 016873): reference interval. Accessed October 28, 2026. https://www.labcorp.com/tests/016873/apolipoprotein-a-1

Updated 2026-10-28. This is general health information, not medical advice: talk to your clinician about your results and before changing any treatment.