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Early detection of heart disease risk is critical if you want to prevent a heart attack. We now know that HDL can be grouped into large and small sizes. Large HDL removes cholesterol from the arteries while small HDL does not participate in this activity. As such it could be important to know if you have large HDL, acting to protect your heart, or small HDL, not adding any protection. LDL carries the so-called "bad" cholesterol. Unlike HDL with one good size and one bad size, all LDL is bad. Small LDLs penetrate the artery wall easier than large LDLs and they are also more easily trapped in the artery wall where their cholesterol can be released to cause plaque build-up. A combination of high numbers of both large VLDL particles and small HDL particles may place an individual at substantial increased risk for heart disease. A simple and inexpensive blood test for high senstivity C-reactive protein (hs-CRP) has proved to be more accurate than cholesterol screening in predicting a person's risk for a heart attack according to researchers at the Brigham and Women's Hospital in Boston.
[NEJM, 3/23/2000].
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