# ApoB: The count of particles that build plaque

> ApoB counts the particles that build plaque in your arteries. Check your result, see the right target for your risk, and what to do if yours is high.

- Also called Apolipoprotein B, Apo B and ApoB-100
- Not on a standard checkup
- No fasting needed
- Web page: https://picardo.health/guides/biomarkers/apob

## The short answer

ApoB is a count of the particles that carry cholesterol into your artery walls. For your heart, lower is better. Labs flag 90 mg/dL or higher, which is also the US target for most people. The higher your risk of heart disease, the lower your target.[3]

- **A good result:** Under 90 mg/dL for most people. Under 70 if your risk is high, and under 55 for most people who’ve had a heart attack or stroke.[3]
- **If yours is high:** It raises your risk over years, not this week. Food changes lower it a little; statins lower it a lot.[3]
- **Should you test?** Yes, if heart disease runs in your family, or you have high triglycerides, diabetes or extra weight. A standard cholesterol test leaves it out.[2][3]

## What is a normal ApoB level?

There are two numbers to know: the lab’s cutoff, and your own target. Labs flag 90 mg/dL or higher. That’s also the US target for most people, but the higher your risk, the lower your target:[3]

Which fits you best?

### Not sure

| Result (mg/dL) | What it means |
| --- | --- |
| Under 90 | Within the lab’s range |
| 90 to 119 | Above the lab’s range |
| 120 to 139 | High enough to count on its own |
| 140 or more | Very high: a statin is recommended whatever your risk |

### No diabetes or heart disease, and a 10-year risk under 10% (target: under 90 mg/dL)

| Result (mg/dL) | What it means |
| --- | --- |
| Under 90 | Under your target |
| 90 to 119 | Above the lab’s range |
| 120 to 139 | High enough to count on its own |
| 140 or more | Very high: a statin is recommended whatever your risk |

### Diabetes, inherited high cholesterol or a 10-year risk of 10% or more (target: under 70 mg/dL)

| Result (mg/dL) | What it means |
| --- | --- |
| Under 70 | Under your target |
| 70 to 89 | Normal on your report, but above your target |
| 90 to 119 | Above the lab’s range |
| 120 to 139 | High enough to count on its own |
| 140 or more | Very high: a statin is recommended whatever your risk |

### A past heart attack, stroke or narrowed arteries (target: under 55 mg/dL)

| Result (mg/dL) | What it means |
| --- | --- |
| Under 55 | Under your target |
| 55 to 89 | Normal on your report, but above your target |
| 90 to 119 | Above the lab’s range |
| 120 to 139 | High enough to count on its own |
| 140 or more | Very high: a statin is recommended whatever your risk |

Your 10-year risk is your chance of a heart attack or stroke in the next 10 years, from the PREVENT calculator clinicians use. With diabetes but no other risk factors, the target is under 90.[3] Heart disease in a parent or sibling at a young age raises your risk too.[3] If you’re not sure which group you’re in, ask your clinician.

### Under your target

**Range:** Under 90 mg/dL for most people; under 70 or 55 if your risk is higher.

Your ApoB is where guidelines want it for someone at your level of risk.[3]

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

**What to do next:**

1. Keep doing what you’re doing.
2. If you’ve never had Lp(a) checked, do it once. It’s inherited, raises heart risk on its own and needs its own test.[2][3]

[Test Lp(a), $16.00](https://app.picardo.health/labs/order?tests=120188&ref=guide-apob)

### Normal on your report, but above your target

**Range:** 55 to 89 mg/dL, if you have diabetes, inherited high cholesterol, a high 10-year risk or past heart disease.

Your lab won’t flag this, because its cutoff is 90. But with diabetes and other risk factors, inherited high cholesterol, a high 10-year risk or a past heart attack or stroke, US guidelines aim lower: under 70, or under 55.[3]

**How worried to be:** Worth acting on over the next few months. It isn’t urgent.

**What to do next:**

1. Ask your clinician whether your treatment should change.
2. Food changes help a little; see how to lower ApoB below.
3. Recheck 4 to 12 weeks after any change.[3]

[Test Lp(a) and HbA1c, $20.00](https://app.picardo.health/labs/order?tests=120188,001453&ref=guide-apob)

### Above the lab’s range

**Range:** 90 to 119 mg/dL.

You have more plaque-building particles than most people. Over years, that raises your risk of a heart attack or stroke, and the more of these particles you carry, and the longer, the more plaque builds.[4]

**How worried to be:** Worth acting on, but not urgent. This is about the years ahead, not this week.

**What to do next:**

1. See a clinician to estimate your overall risk and decide whether you need a medicine.[3]
2. Start with food: swap saturated fat for unsaturated fat.[6]
3. Check Lp(a) and HbA1c. A high Lp(a) favors stronger treatment, and diabetes with other risk factors lowers your target.[3]
4. Recheck 4 to 12 weeks after any change.[3]

[Test Lp(a) and HbA1c, $20.00](https://app.picardo.health/labs/order?tests=120188,001453&ref=guide-apob)

### High enough to count on its own

**Range:** 120 to 139 mg/dL.

US guidelines treat an ApoB of 120 or more as a risk-enhancing factor: when your 10-year risk is borderline, it can tip the decision toward starting a statin.[3]

**How worried to be:** Worth seeing a clinician in the next month or two. It isn’t urgent.

**What to do next:**

1. See a clinician about whether to start a statin.[3]
2. Check Lp(a) and HbA1c. Either can add to your risk.[3]
3. Swap saturated fat for unsaturated fat; see how to lower ApoB below.[6]

[Test Lp(a) and HbA1c, $20.00](https://app.picardo.health/labs/order?tests=120188,001453&ref=guide-apob)

### Very high: a statin is recommended whatever your risk

**Range:** 140 mg/dL or higher.

US guidelines treat an ApoB of 140 or more like an LDL of 190 or more: as severe high cholesterol, where a statin is recommended without first calculating your 10-year risk.[3] Levels this high, especially from a young age, can point to inherited high cholesterol.[2]

**How worried to be:** See a clinician in the next few weeks. It isn’t an emergency.

**What to do next:**

1. See a clinician about starting a statin.[3]
2. Ask about tests for other causes, such as an underactive thyroid or kidney disease, and whether it could be inherited.[3]
3. If it’s inherited, your parents, siblings and children should be tested too.[2]

[Test TSH, a metabolic panel and Lp(a), $25.00](https://app.picardo.health/labs/order?tests=004259,322000,120188&ref=guide-apob)

### Within the lab’s range

**Range:** Under 90 mg/dL.

Your lab won’t flag this. Whether it’s low enough depends on your risk: under 90 is the US target for most people, but it’s under 70 at high risk and under 55 for most people after a heart attack or stroke.[3]

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

**What to do next:**

1. Pick the group that fits you above to see your own target.
2. Check Lp(a) once if you never have. It’s inherited and needs its own test.[3]

[Test Lp(a), $16.00](https://app.picardo.health/labs/order?tests=120188&ref=guide-apob)

## What is ApoB?

> Think of cholesterol as cargo, and the particles carrying it as trucks. LDL cholesterol weighs the cargo; ApoB counts the trucks. It’s the trucks that get stuck in artery walls and start plaque, so the count is what matters most.[1]

Every particle that can build plaque, including LDL, VLDL and Lp(a), carries exactly one ApoB protein. So an ApoB test is a direct count of them.[1]

## How is ApoB different from LDL cholesterol?

For most people, the two tell the same story. They split most often with high triglycerides, diabetes or extra weight: the particles are small and carry less cholesterol each, so LDL cholesterol can look fine while the count is high.[1]

When the two disagree, genetic studies suggest your heart risk follows ApoB.[5]

|  | LDL cholesterol | ApoB |
| --- | --- | --- |
| What it measures | Cholesterol, mostly inside LDL particles | How many plaque-building particles you have |
| Includes Lp(a) | Yes, the cholesterol inside it | Yes, one ApoB for each Lp(a) particle |
| On a standard cholesterol test | Yes | No |

Neither shows how much of the result is Lp(a), so Lp(a) needs its own test.[1][8]

## What raises ApoB?

- Your genes, including inherited high cholesterol, which raises ApoB from birth[2]
- Food high in saturated fat, such as butter, fatty meat and cheese[6]
- Extra weight, insulin resistance and high triglycerides[2]
- An underactive thyroid, kidney disease and some medicines, including steroids[3]

## How to lower ApoB

- **Statins:** Lower LDL cholesterol by 30% to 50% or more, and prevent heart attacks and strokes in large trials.[3] How much it helps: a lot. How sure we are: very sure.
- **Adding ezetimibe or a PCSK9 inhibitor:** Added to a statin, ezetimibe lowers LDL by about another 25%; PCSK9 inhibitors by 45% to 64%.[3] How much it helps: a lot. How sure we are: very sure.
- **Swapping saturated fat for unsaturated fat:** Butter and fatty meat for olive oil, nuts and fish. Trials that replaced saturated fat with vegetable oils cut heart disease by about 30%.[6] How much it helps: some. How sure we are: fairly sure.
- **Losing extra weight:** Mainly lowers triglycerides, and the particle count with them.[2] How much it helps: a little. How sure we are: fairly sure.
- **Plant sterols:** About 2 g a day, from fortified foods such as spreads, lowers LDL by 7% to 10%.[2] Pills are another matter: US guidelines don’t recommend supplements for cholesterol, sterols included.[3] How much it helps: a little. How sure we are: very sure.

Changes show up within weeks, which is why clinicians recheck 4 to 12 weeks after one.[3] For inherited high cholesterol, food alone is rarely enough.[2]

## Who should get an ApoB test?

It’s worth checking if any of these apply to you:

- A parent or sibling had heart disease before 55 (men) or 65 (women).[3]
- You have high triglycerides, diabetes, extra weight or metabolic syndrome.[2]
- Your cholesterol looks normal, but you have other risk factors.[1]
- You’re on cholesterol treatment and want to check it’s working.[2][3]

If you’ve never had Lp(a) checked, add it. US guidelines recommend measuring it at least once in every adult’s life, and European guidelines say it should be considered.[2][3]

## How to get an ApoB test, and what it costs

An ApoB test costs $8.40 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-apob). 17 tests, fast for 12 hours first. ApoB isn’t the whole picture. The panel adds Lp(a), which is inherited, hs-CRP for inflammation, and HbA1c and insulin for blood sugar, plus kidney, liver and thyroid tests. [What’s in it](https://picardo.health/guides/panels/heart-health.md).
- [ApoB on its own, $8.40](https://app.picardo.health/labs/order?tests=167015&ref=guide-apob). Labcorp 167015, 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.

It’s also part of the [Base Core Annual – Men](https://picardo.health/labs/panels/base-core-men) and [Base Core Annual – Women](https://picardo.health/labs/panels/base-core-women) panels, if you want a wider checkup.

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

## Questions people ask

### Will I need a statin if my ApoB is high?

Not necessarily. The decision depends on your overall risk, not ApoB alone. US guidelines count an ApoB of 120 or more as one of the factors that can tip a borderline decision toward a statin. At 140 or more, they recommend one whatever your other risks.[3]

### Can I lower ApoB without medication?

To a degree. Swapping saturated fat for unsaturated fat, losing extra weight and eating foods fortified with plant sterols each lower it modestly.[2][6] If your ApoB is high because of your genes, food changes alone are rarely enough.[2]

### Do I need to fast for an ApoB test?

No. ApoB barely changes after a meal, so you can test at any time of day.[7] If the same blood draw includes tests that need fasting, such as glucose or insulin, follow their instructions.

### Can you have high ApoB with normal cholesterol?

Yes. It’s most common with high triglycerides, insulin resistance or diabetes, where particles are small and carry less cholesterol each, so LDL cholesterol looks normal while the count is high.[1]

### Does ApoB include Lp(a)?

Yes. Each Lp(a) particle carries one ApoB, so it’s part of the count.[1] But Lp(a) is usually a small share of the total, so a normal ApoB can hide a high Lp(a). It needs its own test.

## Often checked alongside

- [Lp(a)](https://picardo.health/guides/biomarkers/lipoprotein-a.md): An inherited particle that raises heart risk
- [LDL cholesterol](https://picardo.health/guides/biomarkers/ldl-cholesterol.md): The main cholesterol behind plaque
- [Triglycerides](https://picardo.health/guides/biomarkers/triglycerides.md): Blood fats that rise with sugar and alcohol
- [HbA1c](https://picardo.health/guides/biomarkers/hba1c.md): Average blood sugar over three months

## Test details

- **Labcorp test:** Apolipoprotein B, 167015
- **LOINC:** 1884-6
- **Sample:** Blood
- **Fasting:** Not needed[7]
- **Typical lab range:** Under 90 mg/dL
- **Units:** mg/dL in the US. For g/L, divide by 100.

## Sources

1. Sniderman AD, Thanassoulis G, Glavinovic T, et al. Apolipoprotein B particles and cardiovascular disease: a narrative review. JAMA Cardiol. 2019;4(12):1287–1295. https://doi.org/10.1001/jamacardio.2019.3780
2. Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111–188. https://doi.org/10.1093/eurheartj/ehz455
3. 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: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153(17):e1154–e1276. https://doi.org/10.1161/CIR.0000000000001423
4. Borén J, Chapman MJ, Krauss RM, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2020;41(24):2313–2330. https://doi.org/10.1093/eurheartj/ehz962
5. Ference BA, Kastelein JJP, Ray KK, et al. Association of triglyceride-lowering LPL variants and LDL-C–lowering LDLR variants with risk of coronary heart disease. JAMA. 2019;321(4):364–373. https://doi.org/10.1001/jama.2018.20045
6. Sacks FM, Lichtenstein AH, Wu JHY, et al. Dietary fats and cardiovascular disease: a presidential advisory from the American Heart Association. Circulation. 2017;136(3):e1–e23. https://doi.org/10.1161/CIR.0000000000000510
7. Nordestgaard BG, Langsted A, Mora S, et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points. Eur Heart J. 2016;37(25):1944–1958. https://doi.org/10.1093/eurheartj/ehw152
8. Kronenberg F, Mora S, Stroes ESG, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J. 2022;43(39):3925–3946. https://doi.org/10.1093/eurheartj/ehac361

Updated 2026-11-03. This is general health information, not medical advice: talk to your clinician about your results and before changing any treatment.