Non-HDL-C and total cholesterol/HDL-C best predictors of heart health

Non-high-density lipoprotein cholesterol (non-HDL-C) and the ratio of total cholesterol to HDL-C are as good as or better than apolipoprotein fractions at predicting future cardiovascular events, according to the results of a prospective study of more than 15,000 women 45 years of age or older from the Women's Health Study.

The study directly compared non-HDL-C, apolipoproteins B100 and A-1, standard lipid measures, lipid ratios, and high-sensitivity C-reactive protein (CRP) as predictors of cardiovascular health. The researchers found that while the magnitude of the association was greater for apolipoprotein B100 than for either total cholesterol or LDL-C, apolipoprotein B100 was highly correlated with non-HDL-C. Since non-HDL-C can be calculated by subtracting HDL-C from total cholesterol at no additional cost, it makes more sense for primary care risk assessment purposes.

In addition, they found that the easily calculated ratio of total cholesterol to HDL-C was equally associated with cardiovascular events as the ratio of apolipoprotein B100 to apolipoprotein A-1.