Questioning Medicine19 Jul 2024

Episode 321: 320. What is the Association of Blood Lipids, Lipoproteins, and Apolipoproteins With Risk of Coronary Heart Disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179824/

This study did something smart in that they broke it down by white black Chinese and then also had 36 lab test they were looking at and they then found look for a black male this one particular blood test apo2 or whatever had better predictive value but that is cherry picking data with lots of data points and we don’t have risk calculators just for black or just for white or just for Chinese population.

Blood test are hot things – we want to be able to drill down someone risk to a factions of a nats rear end but that just isn’t life—all the test and decision tools give us a rough estimate—the goal is to know are we looking at an 8% risk, an 18% risk or a 28% risk. It doesn’t really matter if it is 8.2 or 8.3 or 8.4

Botoom line—I get it we want to do more and be more precise but by getting extra blood test we are also costing the system more money and more energy so until you give me a study that shows it better with then a usuable risk calculator for that particular lab I think the use of these extra lipid labs should stay on the shelf or in the research only setting.

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