Last week I introduced the concept that the present lipid panel is outdated and that the vertical auto profile (VAP) test is much more specific and a better estimate of a person’s cardiovascular risk. This week I will present a couple cases to illustrate how the VAP test can help.
- This process spins the blood in an ultracentrifuge and divides the different subclasses of lipoproteins by weight.
- It then directly measures the amount of each type of lipoprotein in the sample.
55y/o female with strong family history for heart disease:
Regular Lipid Panel:
One would think this woman has no increased risk for heart disease; but with the VAP test:
(Lp(a) cholesterol= an inherited risk factor for atherosclerosis. Also called the “widow maker”)
Goal or Desirable Level < 10 mg/dL
- Knowing this allows a doctor to tailor treatment appropriately: Lp(a) does not respond well to statins.
- 56y/o female whose lipids went UP after starting a diet and fitness program where she ate only 10% fat. (The typical AHA recommendation):
Total Cholesterol=231———went up to 285
LDL=158—————————went up to 180
HDL=55—————————-went up to 63
Triglycerides=90——————went up to 210
In this case VAP Test Results:
- IDL=114 (Goal<20)
- IDL does not respond well to typical lipid lowering therapies of low fat diet, statin or niacin.
- Continue fitness program
Based on the VAP test patient was referred to registered dietician to educate patient on how to restrict carbohydrates and increase her fats to 35% of total calories including mostly monounsaturated fats. One month later VAP test:
- Total LDL=86
As these example cases demonstrate the Vertical Auto Profile is a definitive measurement of a person’s cholesterol and better treatment decisions can be made to help optimize a patient’s risk of heart disease.
Atherotech is the lab that developed the VAP test. It is FDA approved, covered by most medical insurances including Medicare. I would strongly recommend that all physicians research further the evidence behind the Vertical Auto Profile.