What Is the VAP Cholesterol Test?

by Dr. Stephen Sinatra
Filed Under: Diagnostic Tools, Heart Health
Last Reviewed 03/28/2014

The VAP cholesterol test—short for vertical auto profile—is a comprehensive lipid test. 

What Is the VAP Cholesterol Test? In my opinion, compared to the standard lipid profile test, the VAP cholesterol test is far more accurate at identifying how your cholesterol levels may or may not be contributing to your overall cardiac risk.

Merely testing for the amount of total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) doesn’t tell you enough. In fact, monitoring at this level is probably only about 40 percent accurate in predicting risk for heart attack. The VAP cholesterol test, however, is able to break down the most dangerous fractions of cholesterol and provide a more accurate picture of what may or may not be a problem. 

For example, a high LDL cholesterol level is thought to be a heart risk factor.  But LDL, up to a certain level, is really a good guy—a sheep slapped with a wolf’s reputation.  LDL becomes dangerous when it is oxidized or overly present in the form of a small dense particle (known as “LDL-pattern-B”). 

On the other hand, LDL is less dangerous when it is a large, fluffy and more “buoyant” particle. The VAP cholesterol test identifies how much of each kind of LDL you have.

For the VAP cholesterol test, the healthy zone is 70–130 mg/dL total LDL (however, as outlined above; LDL type is also very important).

Sinatra Solutions for Reducing Unhealthy LDL Cholesterol

  • If you are tested and find out that your cholesterol is of the small, dense LDL variety, then you must make some changes to your diet and lifestyle. For starters, adhere to a cholesterol lowering diet, one that includes very few trans fatty acids. Studies have shown that LDL cholesterol particles decrease significantly in size when the consumption of trans fat in the diet increases. Therefore, avoid fried foods as well as margarine and boxed or canned foods, which are often full of trans fatty acids.

  • Another way to change your LDL particle size is to take 1 gram of fish oil daily. High quality fish oil containing DHA (docosahexaenoic acid) has a significant impact on increasing LDL particle size.

  • If your total LDL is above 130 mg/dL and you have documented coronary artery disease and/or diabetes, then statin drugs may be needed.

  • If your doctor doesn't automatically offer the VAP cholesterol test to you, just ask for it.  Most insurance carriers will cover the cost. 

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