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November 09.2025
3 Minutes Read

Why Understanding Remnants Is Key to Heart Health: 4X Worse Than LDL

Heart Disease Remnants vs LDL illustrated with man and artery imagery.

Understanding Lipoproteins: The Real Culprits Behind Heart Disease

In the ongoing battle against heart disease, understanding the various types of lipoproteins and their roles is crucial. When we think of heart health, we often hear about LDL, commonly referred to as 'bad cholesterol.' However, recent discussions suggest there are other lipoproteins, particularly remnants, that might pose an even greater risk—up to four times worse than LDL. This revelation, brought forth by Dr. Elias Bjornson and his research team from the University of Gothenburg in Sweden, shines a light on a less commonly understood but important aspect of cardiovascular health.

In '4X worse than LDL | Heart Disease expert explains', Dr. Elias Bjornson highlights critical insights on lipoproteins that have prompted a deeper examination of cardiovascular risks.

The Role of Lipoproteins in Heart Disease

Lipoproteins are essential components in our blood, acting as vehicles that transport fats and cholesterol throughout the body. There are several types of lipoproteins, but those contributing to heart disease fall primarily into three categories, all carrying a protein called ApoB. Among them, remnants, often classified as triglyceride-rich lipoproteins (TRLs), have been identified as particularly atherogenic. This means they can lead to the buildup of plaques in arteries, potentially causing heart disease.

Why Are Remnants More Atherogenic Than LDL?

Dr. Bjornson’s extensive research focuses on the comparative atherogenicity of remnants versus LDL particles. The hypothesis suggests that despite the fewer numbers of remnants compared to LDLs, their higher cholesterol content per particle makes them more harmful. Where each particle of LDL is a risk factor, remnants may carry more risk based on their composition, suggesting that for the same increase in particle number, remnants could raise cardiovascular risk levels fourfold compared to LDL.

The Weighing Scale: LDL vs Remnants

Most people have a significantly higher number of LDL particles compared to remnants circulating in their blood. For the average individual, while LDL is still the primary contributor to heart disease risk, certain populations, such as those with high triglycerides, can have remnants taking the forefront in risk factors. This becomes particularly significant for individuals who are overweight or have diabetes, where lifestyle management and appropriate health interventions become increasingly vital.

What Can You Do About It?

If you are concerned about your heart health, start by monitoring your lipid levels. A standard lipid panel can help determine your risk factors:

  • Calculate your remnant cholesterol: This can be done by taking your total cholesterol and subtracting your LDL and HDL cholesterol levels.
  • Check your triglyceride levels: High triglycerides can indicate an increased presence of remnants, elevating your risk.
  • Aim to maintain triglyceride levels below 100 mg/dL and work toward achieving a non-HDL cholesterol level under 130 mg/dL.

Making small, consistent lifestyle changes—whether through diet adjustments or regular exercise—can also support better lipid management and heart health.

Wrapping It All Up

Understanding the effects of various lipoproteins on heart disease is paramount in adopting a proactive approach to cardiovascular health. High levels of LDL might be a well-known caution, but remnants emerging as potential offenders in heart disease demonstrate the complexities of our cardiovascular health. It is important to stay informed, continuously monitor your health, and consult healthcare providers to manage and reduce your overall risk of heart disease effectively.

As more is revealed about these mechanisms, the importance of understanding our unique health conditions and managing them holistically becomes clearer. We may not always have access to specific assays for remnants, but knowing how to calculate and manage your risk using the tools and info available can empower you towards a healthier future.

Functional Medicine

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