Heart disease is a silent disease yet there are definitely warning signs. Cholesterol screening has been used to assess risk of heart disease for many years. However, standard cholesterol tests can miss 50 – 80% people who are at risk of developing heart disease. In fact, fifty percent of people who die of a sudden cardiac event have a normal, standard cholesterol profile. We must look beyond the standard profile to see the real risk of developing atherosclerosis and heart disease. There are 7 types of LDL (think lousy, the bad) cholesterol. Some are more dangerous than others and lead to atherosclerosis. There are 5 types of HDL (think healthy, good cholesterol). One type, the HDL2b is the one that is responsible for transporting the LDL back to the liver to be metabolized. Thus it is why the HDL is called the good cholesterol. A person may have a good HDL , but true protection must assure an adequate amount of the HDL2b. The LP(a) is another type of cholesterol that is measured on an advanced lipid profile. When this is elevated, there is a higher risk of stroke. Even though heart disease is a silent disease there are warning signs – we just have to know where to look! The research on Advanced Lipid Profiles that was funded by the government over the last 25 years is so compelling that even Medicare covers the advanced lipid test when indicated and the patient is being actively treated.