ApoB and Lp(a) Test in London: The Heart Markers a Standard Cholesterol Test Misses

ApoB and Lp(a) are two blood markers that show heart and stroke risk a standard cholesterol test can miss. ApoB counts the particles that build plaque in the arteries. Lp(a) is an inherited particle that most people have never had measured, and European guidelines recommend testing it at least once in every adult. At The Wellness in Marylebone, both are included in our Longevity+ panel for £1,395, read by a doctor who writes you a plan.
Written and reviewed by the clinical team at The Wellness. Last updated 23 September 2026.
What does a standard cholesterol test show?
A routine lipid test reports total cholesterol, LDL ("bad") cholesterol, HDL cholesterol, non-HDL cholesterol and triglycerides. It measures how much cholesterol is being carried in your blood. It does not count the particles doing the carrying, and it does not measure Lp(a). For many people that is enough. For some, it gives a reassuring number that hides a real risk.
What is ApoB and why does it matter?
Every particle that can lodge in the artery wall and start plaque (LDL, VLDL, IDL and Lp(a)) carries exactly one apolipoprotein B molecule. So an ApoB result is a direct count of the harmful particles. Two people can have the same LDL cholesterol yet very different particle numbers, and it is the particle number that drives plaque.
The 2019 European Society of Cardiology and European Atherosclerosis Society guidelines recommend ApoB for risk assessment, particularly in people with raised triglycerides, diabetes, obesity or a very low LDL cholesterol, where LDL alone can underestimate risk (ESC/EAS 2019).
What is Lp(a)?
Lipoprotein(a) is an LDL-like particle with an extra protein attached. It is a recognised, independent cause of heart attack, stroke and narrowing of the aortic valve. Your level is set mainly by your genes, so diet and exercise change it very little, and it does not show up in a normal cholesterol test.
The same European guidelines advise measuring Lp(a) at least once in each adult's lifetime, to find the minority with very high inherited levels whose lifetime risk can match that of familial hypercholesterolaemia. In the UK it is not routinely measured in general practice (HEART UK).
Who should consider an ApoB and Lp(a) test?
- A parent, brother or sister who had a heart attack or stroke before 55 (men) or 65 (women).
- A heart attack or stroke yourself at a young age, or with "normal" cholesterol.
- Raised triglycerides, type 2 diabetes, prediabetes or a waist that has crept up.
- Borderline cholesterol and a decision to make about a statin.
- Anyone over 30 who has never had Lp(a) measured and wants a full picture of their risk.
What happens if my result is high?
A high result is a reason to act earlier, not a diagnosis. Your doctor will put it alongside your blood pressure, family history, smoking, glucose and kidney function to estimate your overall risk. High ApoB responds well to diet changes, weight loss and, where appropriate, lipid-lowering medicine. With a high Lp(a), the aim is to bring every other risk factor down harder, and first-degree relatives should consider testing too. We refer to a specialist lipid clinic when results or family history call for it.
How much does an ApoB and Lp(a) test cost in London?
A comprehensive full-day executive health assessment is £2,995. Most people who want these two markers do not need a full day. Our blood panels, all read by a doctor with a written action plan:
- Longevity+, £1,395. More than 100 biomarkers including ApoB, Lp(a), homocysteine, fasting insulin and advanced hormones, with a priority GP results call and a longevity action plan.
- Advanced Health, £650. 55 markers including a full lipid panel, full thyroid, iron studies, glucose and insulin. Does not include ApoB or Lp(a).
- Core Wellness, £350. 30 markers including a full lipid panel and HbA1c. Does not include ApoB or Lp(a).
See every panel on our private blood tests page, or read about longevity medicine if you want a longer-term plan.
How does the test work?
One blood sample, taken in clinic or at a partner laboratory in central London. Most results are back within a few working days. A doctor reviews them, calls you, and sends a written plan that says what to change, what to repeat and when.
Message us on WhatsApp, email team@thewellnesslondon.com or call +44 20 3951 3429. We are open 7am to 9pm every day at 10 Portman Square, Marylebone, and at 9 Eccleston Street, Belgravia SW1W 9LX.
This article is general information and does not replace a consultation. If you have chest pain, sudden breathlessness or signs of a stroke, call 999.
Frequently asked questions
Is ApoB better than LDL cholesterol?
ApoB counts the number of particles that can enter the artery wall, while LDL cholesterol measures how much cholesterol they carry. The two usually agree. When they disagree, which is common with raised triglycerides, diabetes, excess weight or a very low LDL, ApoB is the more accurate guide to risk, which is why European guidelines recommend it for these groups.
How often should Lp(a) be tested?
For most people, once. Lp(a) is set largely by your genes and changes little across adult life. European guidelines recommend measuring it at least once in every adult.
Do I need to fast for an ApoB or Lp(a) test?
Neither marker needs fasting on its own. If the same sample includes fasting glucose or insulin, we will ask you to fast for 8 to 10 hours, and we tell you this when you book.
How much does an ApoB and Lp(a) test cost in London?
At The Wellness both markers are included in Longevity+, our panel of more than 100 biomarkers, which is £1,395 and includes a priority results call with a doctor and a written action plan.
Speak to the team about blood testing
Request a time in Marylebone or by video, or read about the service and its prices first.