# Apolipoprotein B - aka apoB

## About

Apolipoprotein B, aka apo(b) is a protein found on the surface of various lipoprotein particles in your blood. These lipoproteins are essentially packages that transport cholesterol and other fats throughout your body. Here's why apo(b) is important for cardiovascular health:

* **Carries Cholesterol:** apo(b) is the main protein component of LDL ("bad") cholesterol. LDL particles carry cholesterol from your liver to other parts of your body.
* **Risk Factor for Heart Disease:** High levels of apo(b), particularly from LDL, are a major risk factor for atherosclerosis, the buildup of plaque in your arteries. This plaque can narrow your arteries and restrict blood flow, potentially leading to heart attack or stroke.
* **More Comprehensive Measure:** Unlike simply measuring LDL cholesterol, apo(b) levels can also reflect cholesterol carried by other lipoproteins like VLDL (very-low-density lipoprotein) and IDL (intermediate-density lipoprotein). This provides a more complete picture of your overall cholesterol transport activity.

In summary, apo(b) plays a key role in transporting cholesterol, and high levels are associated with an increased risk of cardiovascular disease. Therefore, monitoring and managing apo(b) levels can be an important part of maintaining good heart health.

## How to lower it

Peter Attia, MD, reclaimed author of Outlive, discusses various approaches to lowering apolipoprotein B apo(b) levels, a risk factor for cardiovascular disease (ASCVD), in his [How to lower your apoB](https://www.youtube.com/watch?v=wVg9rc69UMs) video. Here are the key takeaways:

* **Modern Options:** Compared to 20 years ago, there are numerous tools beyond high-dose statins for managing apoB.
* **Focus on Pharmacology:** Exercise has minimal impact on apoB, while medications and diet are the most effective strategies.
* **Dietary Strategies:** Two main approaches are reducing carbohydrates (lowers triglycerides) and saturated fat (reduces cholesterol synthesis and increases LDL receptor activity). However, maintaining a very low-carb, low-saturated fat diet might be challenging and unnecessary for everyone.
* **Statin Concerns:** High-dose statins offer diminishing returns in efficacy and may cause side effects like muscle aches, liver issues, and insulin resistance. Lower doses with minimal side effects are preferred.
* **Alternative Medications:** Newer medications like PCSK9 inhibitors and bempedoic acid can be more potent and have different mechanisms of action compared to statins. However, they are currently expensive.
* **Future of LPA Management:** Antisense oligonucleotide drugs are being developed to target apo(a), a protein component of LDL particles. These drugs show promise in lowering apo(a) levels, but their effectiveness in preventing cardiovascular events and long-term safety need further investigation.

Click [here](/e4JFLkKxSt2hyxNF0WmZ9w) for full transcript