Got high cholesterol? Here’s what you should check next, according to research and longevity experts.

Our bodies need cholesterol to build the structure of cell membranes, make key hormones and bile acids needed to digest and absorb fats as well as vitamin D. Cholesterol is essential for your body, but what happens if cholesterol levels are elevated?

If your doctor tells you your cholesterol levels are too high, here is what you should be checking next:

Is LDL high? Is HDL high? When you get your cholesterol checked, the doctor looks not only at total cholesterol, but also the HDL (high-density lipoprotein), LDL (low-density lipoprotein) as well as VLDL (very-low-density lipoprotein) cholesterol. Some doctors also look at triglycerides. People with high levels of HDL cholesterol are less likely to develop cardiovascular disease (CVD), whereas high levels of triglycerides, LDL or VLDL cholesterol are linked to atherosclerosis, which is the accumulation of cholesterol-rich fatty deposits in arteries. This can cause arteries to narrow or become blocked, which slows or stops the flow of blood to vital organs like the heart and brain. Atherosclerosis affecting the heart is called coronary artery disease, and it can cause a heart attack. When atherosclerosis blocks arteries that supply blood to the brain, it can cause a stroke. Note that even if your total cholesterol is in the desirable category, it’s possible that you may have unhealthy levels of HDL (low level), LDL/ VLDL (elevated levels), Lp(a) or Apo (B).
Get Lp(a) (Lipoprotein A) checked. Longevity expert Dr. Peter Attia explains that elevated Lp(a) is the single most important and most prevalent hereditary risk factor for cardiovascular disease. Recent studies show that high Lp(a) numbers promote clotting and inflammation, significantly increasing risk of heart attack, stroke, aortic stenosis and peripheral artery disease. A 2024 study concluded that Lp(a) is markedly more atherogenic than LDL. You should get Lp(a) checked especially if you have familial hypercholesterolemia (i.e. if high cholesterol runs in the family) or if you have signs of coronary heart disease.
Get LDL-P (i.e. ApoB) checked. Apolipoprotein B (ApoB) is a major protein component of LDL. It facilitates the transportation of LDL and lipids to the peripheral tissues throughout the body. Evidence favors ApoB over LDL as a predictor of cardiovascular events. Dr. Peter Attia notes that even if your standard lipid (cholesterol) panel results are within the normal range, ApoB test results may be high, so it is important to include this biomarker when assessing heart health. In fact, Dr. Allan Sniderman, an expert professor of cardiology and medicine at McGill University, thinks that ApoB is currently being underutilized; not enough physicians are checking for ApoB status.

Dr. Ardyce Yik offers testing of all the aforementioned biomarkers for cardiovascular health. If any of these markers are out of normal range, she can discuss the benefits of medicines, nutraceuticals, exercise and diet in your particular case. Your liver produces and controls 70 to 80% of cholesterol, so when it comes to managing cholesterol in your body, she will also look at ensuring optimal liver function.

Click here for more health tests you should consider doing if you’re between the ages of 40 to 60, according to longevity experts.