Have you heard of VAP? You will. It's a newly developed cholesterol test. It stands to make your total cholesterol number obsolete.

Total blood cholesterol is not a very good predictor of heart attack or stroke. Many people with high cholesterols never have a heart problem and half of the people who have heart attacks have normal cholesterol levels. Nevertheless, we know that cholesterol plaguing in the arteries can be a factor in both heart attacks and stokes.

The VAP (Vertical Auto Profile) cholesterol test provides a more thorough approach to cholesterol testing. VAP was developed to satisfy the new cholesterol guidelines set by the National Cholesterol Education Program (NCEP). The guidelines call for a more aggressive role in diagnosing and treating high cholesterol.

I disagree with the treatment recommendations portion of the new guidelines. Under the guidelines, millions more Americans will be asked to take dangerous cholesterol-lowering drugs and no mention is made of safer natural alternatives. But accurate early assessment of risk is important. And that will be aided by the new VAP test.

* New Measurements *

New cholesterol research has demonstrated what some of us have been saying for years. That is, that total blood cholesterol is just one piece in a complex puzzle. Other factors like homocysteine and C-reactive protein are actually more important but are being neglected.

VAP improves the predictive value of cholesterol testing by introducing five new categories of cholesterol measurement. Among the most important new measurements are Lp(a) and LDL pattern size.

Research has proved that the size of cholesterol-carrying particles is more important than the amount of cholesterol in your blood. Some of the most dangerous are a type of lipoprotein called Lp(a). These particles help determine whether cholesterol will stay soluble in your blood where it is harmless. Or whether it will precipitate into cholesterol plague narrowing your arteries.

There is a strong statistical link between Lp(a) and heart attacks. Researchers at The University of Pittsburgh have reported that high levels increase heart attack risk by 300% making it a better cardiac predictor than traditional cholesterol tests.

Smaller lipoprotein particles are dangerous. They are dense and heavy making them more likely to precipitate. The larger lighter particles cause less buildup on blood vessel walls.

* The Difference *

The VAP test costs about the same as routine tests. It is covered by most insurance. Discuss it with your doctor. He can order it from the manufacturer, Atherotech.

The traditional cholesterol test sometimes scares people (and their doctors) with false alarms. The new parameters should be used to reassure them. Even more importantly, the old test only picks up about 45% of cholesterol abnormalities. Atherotech's data suggests the new test can show 90% of cholesterol abnormalities. You can learn more about the VAP test by visiting their website: www.atherotech.com.

Al Sears MD