Lab marker
LDL-C
LDL cholesterol · Low-density lipoprotein cholesterol
The historically dominant cardiovascular marker: informative, but ApoB captures the same risk signal more precisely.
What it measures
Cholesterol cargo carried by low-density lipoprotein particles. Reported either by direct measurement or calculated from total cholesterol, HDL, and triglycerides via Friedewald or Martin/Hopkins equations.
Reference context
3 guideline sources
Calculated LDL-C is unreliable when triglycerides are >400 mg/dL. When ApoB and LDL-C disagree, ApoB is the more accurate particle-count metric.
Population context: consult guideline targets below
Mechanism
Why moving this marker matters
LDL particles entering the arterial wall and being retained drive atherogenesis. LDL-C correlates with particle number in most people but can diverge meaningfully when particles are small and dense (high TG, metabolic syndrome), which is why ApoB has gained ground as the preferred metric.
Guideline targets
What major guidelines recommend
ESC 2021 (low risk)
<116 mg/dL (<3.0 mmol/L)
ESC 2021 (high CV risk)
<70 mg/dL (<1.8 mmol/L) + 50% reduction
ESC 2021 (very-high CV risk)
<55 mg/dL (<1.4 mmol/L) + 50% reduction
How to measure
The test, where to get it, when to repeat
Method
Standard lipid panel. Fasting traditionally preferred but non-fasting acceptable in most modern guidelines.
Where
Standard GP panel everywhere.
Typical cost
Bundled with the lipid panel.
Fasting
Not required
When to test
ESC 2021
40+Part of routine cardiovascular risk assessment from age 40.
Where to test
Independent labs offering this test
Healicus refers you to independent laboratories. You order from the lab; they take the sample, run it, and return your result on their own platform. Healicus never sees your value.
Randox Health
UK · EU · INTLClinic-based premium panels — wider biomarker breadth than home-test brands.
Visit Randox Health
Synlab
DE · EU · INTLEurope-wide medical lab network — referrals via partner GPs and direct-to-consumer programmes where offered.
Visit Synlab
Medichecks
UKUKAS-accredited home blood-test panels with GP-equivalent biomarker coverage.
Visit Medichecks
Thriva
UKApp-first subscription home testing, capillary draw, clinician-reviewed reports.
Visit Thriva
Healicus is not the provider. Your contract for the service is with whoever you choose. Links labelled Sponsored are paid affiliate relationships; unlabelled links are editorial reference only. See our disclosure for the full policy.
Context
Reading the numbers
Calculated LDL-C is unreliable when triglycerides are >400 mg/dL. When ApoB and LDL-C disagree, ApoB is the more accurate particle-count metric.
Caveats
Direct vs calculated LDL-C can differ meaningfully. Inflammation, recent illness, and acute weight loss all shift values transiently.
Practices
What's been shown to influence this marker
Mediterranean dietary pattern reduces LDL-C modestly (~5–10%) in PREDIMED-derived analyses, more in those with metabolic syndrome.
Soluble fibre (~10g/day above baseline) reduces LDL-C by ~5–7% via bile-acid sequestration. Most evident with psyllium, oats, legumes.
HabitMediterranean dietary pattern
Olive oil, fish, nuts, legumes, plants. The most-studied diet for cardiovascular and cognitive longevity.
Why
The Mediterranean pattern, heavy on plants, olive oil, fish, nuts, legumes; moderate fish and dairy; light on red meat, has the strongest evidence base of any specific diet for long-term cardiovascular and cognitive outcomes. PREDIMED, the largest trial, showed ~30% reduction in major cardiovascular events vs. low-fat control.
Slot in your day
How to do it
How
Olive oil as the primary fat. Plants at every meal. Fish 2–3× per week. Nuts daily (small handful). Red meat once a week or less. Wine optional, with food.
Sticking with it
Stock the kitchen for one week's pattern. Decisions live in the shopping list, not at mealtime.
Markers this may influence
Evidence
PREDIMED (Estruch 2018 NEJM, n=7,447, 4.8-y follow-up): a Mediterranean diet plus extra-virgin olive oil or mixed nuts vs. a low-fat control diet, ~30% reduction in major cardiovascular events (MI, stroke, CVD death). Sofi 2014 updated meta-analysis (n>4M) confirms a dose-response association with all-cause and cardiovascular mortality.
SupplementOmega-3 (EPA + DHA)
Cardiovascular and cognitive benefits at 1–2g combined EPA+DHA. Skip if you eat 2+ servings of fatty fish weekly.
Why
EPA and DHA are long-chain omega-3 fatty acids primarily from fatty fish. They reduce triglycerides, support cell membrane function, and are concentrated in brain tissue. Supplementation is most useful for people who don't eat fatty fish regularly. Algae-derived versions exist for vegetarians.
How it works
Incorporated into cell membranes; competes with arachidonic acid in eicosanoid synthesis, shifting inflammatory signalling toward resolution.
Expected onset · ~12 weeks for steady-state membrane uptake
How to take
Dosage
1–2g combined EPA+DHA daily (check the label, total fish oil weight is misleading).
Timing
With a meal containing fat
On the label
Look for combined EPA+DHA per serving on the label, not just 'fish oil 1000mg'. Third-party tested for purity (IFOS, USP).
Ideal for
Anyone who eats fatty fish less than twice per week.
Safety
Markers this may influence
Evidence
EFSA Reg 432/2012 authorised the health claim that EPA and DHA contribute to normal heart function at a combined intake of ≥250 mg/day, a cause-and-effect relationship established from pooled human trial data. Most useful for adults eating fatty fish less than twice per week; algae-derived sources are equivalent for vegetarians.
Where to get it
Shop Omega-3 (EPA + DHA) on AmazonSponsored · As an Amazon Associate, Healicus earns from qualifying purchases.
Habit30g fiber/day
Most adults eat half what they need. Strong dose-response with all-cause mortality.
Why
Fiber feeds gut microbiota, slows glucose absorption, supports cardiovascular health, and predicts mortality independent of other dietary factors. Most adults consume 12–15g/day; the target for cardiovascular benefit is 25–30g+. Whole foods (legumes, vegetables, oats, berries) are better sources than supplements.
Slot in your day
How to do it
How
Add a serving of beans/lentils most days. Berries with breakfast. Vegetables at lunch and dinner. Tracked once for a week, the gap to 30g becomes obvious.
Markers this may influence
Evidence
Reynolds 2019 Lancet meta-analysis (185 prospective studies and 58 RCTs, commissioned by WHO): highest vs lowest fibre consumers had 15–30% lower all-cause and cardiovascular mortality, with the steepest risk reduction at 25–29 g/day intake. Dose-response suggests further benefit above 30 g/day. Most adults consume 12–15 g.
See also
Related markers
Take to your physician
Worth discussing
- Whether LDL-C or ApoB is more useful for your risk profile.
- If on a statin, the LDL-C target appropriate to your risk category.
- If LDL-C and ApoB disagree, which to act on (usually ApoB).
Sources
Cited literature
Last reviewed May 2026
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