Standard lipid panel
- Total cholesterol
- LDL (“bad” cholesterol)
- HDL (“good” cholesterol)
- Triglycerides
For patients and physicians
A standard cholesterol test shows only part of the picture.
A lipid evaluation adds
- ApoB: counts the particles that build plaque
- Lp(a): an inherited risk most people never test
- Family history and genetics
- What you’ve tried and what you tolerate
Buffalo Lipid Medicine · Andrew Gaddi, DO · 716-800-2-LPA
Cholesterol damage adds up. Starting early buys decades.
Plaque builds with total LDL exposure over the years, not one bad lab result.
Lifetime LDL exposure
Age (years)
- FH, untreated
- Typical LDL
- FH, treated early
Dotted line: the level where heart attacks often begin. The gold span below is the decades between untreated FH and FH treated early, in this illustration.
About age 35Decades gainedAbout age 60
Illustration numbers
Relative lifetime exposure, not a lab value. Threshold is drawn at 100. Untreated FH crosses it near 35, typical LDL near 55, treated FH near 60.
Illustration of the “cholesterol-years” concept, not individual data. Adapted from Nordestgaard et al., Eur Heart J 2013. FH = familial hypercholesterolemia.
Familial hypercholesterolemia (FH) runs in families.
FHParent with FH
FH
FH
Each child has a 1 in 2 chance.
Brothers, sisters and parents too.
1 in 250
people have FH. High LDL starts at birth.
Most
people with FH don’t know they have it.
Find one case, protect a family. Testing relatives catches FH before the first heart attack.
Sources: World Heart Federation; Mayo Clinic study, Circ Genom Precis Med 2025. Buffalo Lipid Medicine · 716-800-2-LPA
Lp(a): common, inherited, and almost never checked.
1 in 5 people have high Lp(a)
20%
2 in 1,000 Americans were tested over 10 years
0.2%
One blood test.
Usually needed once in a lifetime. It is not part of a standard cholesterol panel, so you have to ask for it.
Sources: American Heart Association; Ramsis et al., JACC: Advances 2025 (0.2% of the U.S. population tested, 2015–2024). Buffalo Lipid Medicine · 716-800-2-LPA
More than half of Black adults have high Lp(a).
Share of U.S. adults with Lp(a) of 30 mg/dL or higher
Black58%
White25%
Hispanic24%
Chinese American19%
High Lp(a) shows up in every group. Your background can’t rule it out. One blood test can.
Source: Multi-Ethnic Study of Atherosclerosis, 4,593 adults. Guan et al., Arterioscler Thromb Vasc Biol 2015. Buffalo Lipid Medicine · 716-800-2-LPA
Triglycerides: when to look closer.
Fasting triglycerides, mg/dL
Under 150
Normal
Keep up healthy habits and routine checks.
150 – 499
Elevated
Adds to heart risk. Look for causes: diabetes, thyroid, kidneys, medicines, alcohol, genetics.
500 and up
Severe
Raises the risk of pancreatitis, especially above 1,000. Needs prompt attention.
Still above 200 after treatment, or ever above 500? A lipid specialist can find the cause and the right plan.
Categories per national cholesterol guidelines. Buffalo Lipid Medicine · 716-800-2-LPA
The earlier you lower cholesterol, the more it protects you.
Like years of smoking, years of high cholesterol add up.
How many fewer heart attacks, for the same drop in LDL:
Lowered from early in life
55%
Lowered later in life
24%
Per 39 mg/dL lower LDL. Ference et al., JACC 2012; Cholesterol Treatment Trialists, Lancet 2010. Buffalo Lipid Medicine · 716-800-2-LPA
What are “cholesterol-years”?
Like pack-years for smoking, they measure how much cholesterol your arteries have taken in over time.
LDL levelYearsCholesterol-years
Same buildup, two ways:
4,000
for 20 years
4,000
for 40 years
The bigger the total, the higher the risk.
Lowering LDL, and starting sooner, keeps the total small.
Simplified illustration; LDL in mg/dL. Buffalo Lipid Medicine · 716-800-2-LPA