A standard lipid panel is the starting point for blood-test assessment of cardiovascular risk. It measures total cholesterol, LDL-C, HDL-C and triglycerides. High-sensitivity C-reactive protein (hs-CRP) can indicate inflammation and may refine risk assessment in selected situations; lipoprotein(a) (Lp(a)) and apolipoprotein B (ApoB) can add information about inherited risk and atherogenic particles. None of these results, alone, diagnoses heart disease.
Which blood tests assess inflammation and cardiovascular risk?
| Test | What it measures | How it may help |
|---|---|---|
| Lipid panel | Total cholesterol, LDL-C, HDL-C and triglycerides | Routine starting point for estimating atherosclerotic cardiovascular disease (ASCVD) risk. |
| hs-CRP | Low levels of C-reactive protein, a marker of inflammation | May contribute to a risk discussion; it is not specific to cardiovascular inflammation. |
| Lp(a) | An LDL-like cholesterol-carrying particle, with levels that are mostly inherited | Identifies an additional inherited risk factor associated with heart attack, stroke and aortic stenosis. |
| ApoB | A measure reflecting atherogenic lipoprotein particles | Can clarify risk or treatment decisions for selected people, including some with high triglycerides or diabetes. |
These tests answer different questions: cholesterol levels, particle-related risk, or inflammation. Their results need to be interpreted alongside a person’s overall health and risk profile.
What does a standard lipid panel tell you?
A lipid panel reports total cholesterol, LDL-C, HDL-C and triglycerides. It is the routine foundation for cardiovascular blood-test assessment, but it is not a complete risk assessment by itself.
Under the 2018 ACC/AHA cholesterol guideline, either a fasting or nonfasting lipid profile is effective for estimating ASCVD risk in adults who are not taking lipid-lowering therapy. Follow the ordering clinician’s instructions for your particular test. Read the 2018 ACC/AHA cholesterol guideline.
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When can hs-CRP help?
hs-CRP measures small amounts of C-reactive protein in the blood. The American Heart Association describes CRP as an inflammation marker linked with increased heart attack or stroke risk. Because it is not specific to inflammation in the cardiovascular system, a higher result does not establish that a person has heart disease. It may help refine a risk discussion when interpreted in clinical context.
The 2019 ACC/AHA primary prevention guideline listed hs-CRP of at least 2.0 mg/L as a risk-enhancing factor. That figure belongs to the guideline’s risk framework; it is not a standalone diagnosis or a complete current treatment rule. See the 2019 ACC/AHA primary prevention guideline.
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Why ask about an Lp(a) test?
Lp(a) is an LDL-like particle, and levels are mostly inherited. The 2026 ACC/AHA dyslipidemia guideline recommends measuring Lp(a) at least once in all adults for ASCVD risk assessment. The test is ordered separately from a standard lipid panel. The CDC notes that elevated Lp(a) is associated with heart attack, stroke and aortic stenosis. CDC: About Lipoprotein (a).
The 2019 ACC/AHA primary prevention guideline listed Lp(a) of at least 50 mg/dL or 125 nmol/L as a risk-enhancing factor. These are values in two different units; they should not be treated as interchangeable using one universal conversion. The 2019 figures are historical guideline context, not a substitute for current individualized assessment.
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Who might benefit from ApoB testing?
ApoB reflects atherogenic lipoprotein particles and can add detail when standard cholesterol values do not fully clarify risk. The 2026 guideline supports selective ApoB measurement, including for some people with high triglycerides, diabetes or cardio-kidney-metabolic risk. A clinician may use the result to decide whether additional lipid treatment is appropriate; ApoB is not necessarily needed for everyone.
The 2019 ACC/AHA primary prevention guideline listed ApoB of at least 130 mg/dL as a risk-enhancing factor. Treat that as a threshold within that historical framework, not as a universal diagnosis or a complete current treatment algorithm.
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How do clinicians put the results together?
Blood-test results are considered with other information rather than used in isolation. The 2026 dyslipidemia guideline highlights PREVENT-ASCVD equations for risk assessment and coronary artery calcium imaging in selected cases when further risk refinement is useful. A clinician can determine which tests or follow-up make sense for an individual’s history and risk profile. Read the AHA summary of the 2026 dyslipidemia guideline.
- Start with a lipid panel to see cholesterol and triglyceride values.
- Discuss hs-CRP if an inflammation marker could help inform the risk conversation.
- Ask about an Lp(a) measurement at least once as an adult.
- Consider ApoB selectively when additional information about atherogenic particles could affect assessment or treatment.
The 2026 ACC/AHA dyslipidemia guideline states: “In all adults, measurement of Lp(a) concentration is recommended at least once for ASCVD risk assessment.” Read the 2026 ACC/AHA dyslipidemia guideline.
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