New practical guide: Lipid Monitoring for Cardiovascular Risk

BannerThe Forever Healthy Foundation proudly announces the third publication by its “Maximizing Health” initiative:

Lipid Monitoring for Cardiovascular Risk – A practical guide on lipid biomarkers and the best monitoring protocol

The “Maximizing Health” initiative reviews the latest medical knowledge and creates actionable guides to empower informed decisions about health and well-being.


Numerous aspects of lipid metabolism have been implicated in the genesis of cardiovascular disease (CVD). Given the prevalence and mortality of CVD, it is essential to identify optimal biomarkers of lipid metabolism that may provide better risk prediction. Several lipid biomarkers have been proposed for monitoring, and several methods have been developed for measuring them. This Practical Guide aims to identify those markers, evaluate their relevance to CVD risk prediction, and determine the best lipid monitoring protocol available at the moment.


A list of potential lipid parameters was compiled from medical and laboratory resources. A literature search was then conducted on PubMed for each parameter. Additionally, we reviewed the major clinical practice guidelines on lipid monitoring.
Our search identified 21 lipid biomarkers ranging from those included in a standard lipid panel to those that are just entering clinical practice. For each biomarker, the main evidence for and against its use in CVD risk prediction was summarized. The available information on test types, standardization & error, reference values, factors affecting measurement, and frequency of testing for each parameter was analyzed.


The following chart illustrates our results by comparing lipid biomarkers in terms of their association with CVD and the total error of the analytical technique used to measure them.


According to our analysis, only two of the markers are both closely associated with cardiovascular risk and have an acceptable level of error: apolipoprotein B (ApoB) and total cholesterol (TC). There are several other markers that have stronger associations with CVD risk and may present valuable information, however, the test results are less reliable, due in most cases, to a lack of standardization or a low level of accuracy.

The full analysis including a detailed lipid monitoring protocol based on the findings of our research can be found here.