THE LIPOPROTEIN & CARDIOMETABOLIC HANDBOOK

Look beyond
the cholesterol
number.

Understand the particles, the pathways, and the metabolic connections that shape cardiovascular risk.

Start reading Explore the handbook

Luis F. Aparicio, MD, FACEMetabolic Disease Associates · Erie, Pennsylvania

A COMPANION TO
COUNTING WHAT COUNTS

The Lipoprotein
& Cardiometabolic
Handbook

LUIS F. APARICIO, MD, FACE

52 CHAPTERSONE CONNECTED PERSPECTIVE

52 focused chapters5 connected sectionsFrom fundamental biology to clinical prevention

A REFERENCE YOU CAN RETURN TO

The science.
The connections.
The bigger picture.

The lipid panel is a starting point. This handbook explores what lies behind it: lipoprotein transport, ApoB-containing particles, atherosclerosis, and the physiology of metabolic health.

Read from the beginning or go straight to a question. Each chapter brings together the underlying biology, clinical relevance, common misconceptions, and practical takeaways.

A companion to Counting What Counts

FIND YOUR STARTING POINT

Follow your curiosity.

What does
ApoB tell us?

Begin with the protein at the center of particle counting.

Read chapter 4 02 / METABOLISM

Where does insulin
resistance fit?

Explore the connection between metabolism and cardiovascular risk.

Read chapter 40 03 / PREVENTION

How do we see
the whole patient?

Connect the history, the measurements, and the clinical picture.

Read chapter 35

THE COMPLETE HANDBOOK

Understanding, chapter by chapter.

Five sections. Fifty-two chapters.
Read in order, or make your own path.

SECTION ICHAPTERS 1–11

Foundations

The molecules, particles, and transport systems behind every lipid panel.

01CholesterolThe Molecule Every Cell Needs and No One Should Fear4 min 02LipoproteinsThe Transport System Cholesterol Cannot Do Without4 min 03ApolipoproteinsThe Proteins That Decide Where Every Particle Goes3 min 04Apolipoprotein BOne Molecule, One Particle, One Number That Counts4 min 05The Life Cycle of LipoproteinsOne Continuous System, Not Five Separate Particles4 min 06ChylomicronsThe Body's Delivery Truck for Every Fat-Containing Meal4 min 07Very-Low-Density LipoproteinsHow the Liver Exports What It Cannot Store4 min 08Intermediate-Density LipoproteinsThe Fork in the Road Between VLDL and LDL3 min 09Low-Density LipoproteinsWhy "Bad Cholesterol" Is the Wrong Way to Say It4 min 10High-Density Lipoproteins"Good Cholesterol" Is Not Cholesterol Either5 min 11Reverse Cholesterol TransportThe Body's Return Route for Excess Cholesterol4 min

SECTION IICHAPTERS 12–21

Atherosclerosis

From the arterial wall to plaque, inflammation, and lifetime exposure.

12The EndotheliumWhere Atherosclerosis Begins4 min 13The LDL ReceptorThe Body's Main Exit Door for Atherogenic Particles4 min 14PCSK9The Switch That Decides How Many Receptors Survive4 min 15Lipoprotein(a)The Risk Factor Your Genes Set Once, for Life4 min 16Remnant LipoproteinsThe Risk That Hides Behind a Normal LDL3 min 17Why ApoB Causes AtherosclerosisThe Response-to-Retention Hypothesis, Explained4 min 18Inflammation and AtherosclerosisLipids Start the Fire; Inflammation Keeps It Burning4 min 19Plaque RegressionCan Atherosclerosis Be Reversed?3 min 20The Silent YearsCardiovascular Disease Begins Long Before Symptoms3 min 21The Importance of TimeWhy Earlier Is Better3 min

SECTION IIICHAPTERS 22–39

Diagnosis & Treatment

The tests, mechanisms, and therapies used in cardiovascular prevention.

22Cholesterol HomeostasisThe Balance Every Lipid-Lowering Drug Works Through3 min 23Cholesterol SynthesisThe Mevalonate Pathway3 min 24Cholesterol AbsorptionNPC1L1 and ABCG5/ABCG83 min 25Cholesterol EliminationBile Acids and Biliary Excretion3 min 26StatinsWhy the Most-Studied Drug in Medicine Works the Way It Does4 min 27EzetimibeA Different Door to the Same Destination4 min 28Bempedoic AcidA Statin Alternative That Never Reaches the Muscle4 min 29ANGPTL3 InhibitorsLowering ApoB Without Touching the LDL Receptor4 min 30TriglyceridesMore Than an Energy Storage Molecule4 min 31Remnant CholesterolThe Number You Can Calculate for Free3 min 32Non-HDL CholesterolEvery Atherogenic Particle in One Free Calculation3 min 33LDL Cholesterol vs. ApoBWhy They Are Not the Same3 min 34Advanced Lipid TestingWhen the Standard Lipid Panel Is Not Enough3 min 35Evaluating the Patient at Cardiovascular RiskWhere a Real Workup Begins4 min 36A Practical Approach to Lipid-Lowering TherapyPutting the Drug Classes to Work3 min 37Measuring SuccessBeyond the Lipid Panel3 min 38Precision PreventionThe Right Treatment for the Right Patient3 min 39Putting It All TogetherA New Way of Understanding Cholesterol4 min

SECTION IVCHAPTERS 40–49

Cardiometabolic Medicine

Connecting insulin resistance, energy metabolism, fitness, and healthspan.

40Insulin ResistanceThe Engine of Cardiometabolic Disease4 min 41The Cardiometabolic ContinuumOne Disease Process, Many Names3 min 42Adipose TissueMore Than Energy Storage3 min 43Energy PartitioningWhy the Body Does More Than Count Calories4 min 44Metabolic HealthLooking Beyond Blood Glucose3 min 45Metabolic FlexibilityThe Hallmark of Metabolic Health4 min 46Skeletal MuscleThe Body's Largest Metabolic Organ3 min 47MitochondriaThe Powerhouses of Cardiometabolic Health3 min 48Cardiorespiratory FitnessOne of the Strongest Predictors of Longevity4 min 49HealthspanAdding Life to Years3 min

SECTION VCHAPTERS 50–52

The Future

Risk-based prevention and the next chapter of preventive cardiology.

50Risk-Based PreventionMatching Treatment to Risk3 min 51Residual Cardiovascular RiskWhy Events Still Occur Despite a Good LDL Cholesterol3 min 52The Future of Preventive CardiologyFrom Treating Heart Attacks to Preventing Them4 min

01 / LOOK IT UPThe glossaryKey terms, clearly defined ↗02 / KEEP IT HANDYQuick referenceParticles, proteins, therapies & biomarkers ↗03 / BRING IT TOGETHERKey conceptsThe handbook’s central ideas ↗

THE PURPOSE OF PREVENTION

“Medicine is at its best when it prevents suffering before it occurs.”

Read the epilogue