Are you getting the full picture of your heart health? Cardiovascular disease is a leading cause of death, making it essential to understand the best tools for prevention to take control of your health. In Episode #339, I’m joined by Dr Dan Soffer, a preventive cardiologist and lipidologist, to discuss why ApoB is the test you shouldn’t skip. Discover how this test can give you a clearer understanding of your cardiovascular risk, empowering you to make smarter, proactive choices for your long-term health.
“This is not an experimental test. This is as close to done science as we can get. This is a highly validated, reproducible, high-quality test that demonstrates residual atherosclerotic cardiovascular risk due to lipid and lipoprotein abnormalities.”
Dr Dan Soffer is a clinical lipid specialist and Associate Professor of Clinical Medicine at the Perelman School of Medicine at the University of Pennsylvania. As the Director of Education for Preventive Cardiology and Clinical Lipidology at Penn, Dr Soffer has dedicated his career to educating both clinicians and patients on the role of lipids in cardiovascular health. He is also the co-director of the Preventive Cardiology Fellowship program and is actively involved in multiple educational, research, and leadership activities within the National Lipid Association (NLA), where he served as President. With a focus on translating complex science into accessible information, Dr Soffer emphasises early intervention and understanding inherited lipid disorders.
“The longer you let your LDL cholesterol to be elevated and your ApoB to be elevated, the more atherosclerosis forms, and if we wait too long… then we probably have to use a more intensive strategy. If you start early, you can use a less intensive pharmacologic strategy.”
In this episode, you’ll learn why ApoB provides more comprehensive insights than LDL cholesterol alone, who can benefit most from this test, and how it fits into preventive cardiology. Dr Soffer shares practical advice for assessing cardiovascular disease risk, discusses the implications of diet and genetics on heart health, and explores case studies to help you understand when and why ApoB testing is crucial.
Specifically, we cover:
- Introduction (00:00)
- Insight into Preventive Cardiology and Lipidology (01:38)
- Understanding Lipoproteins and Their Role in Cardiovascular Disease (06:40)
- Techniques for Lipoprotein Testing and Measurement (11:33)
- Exploring Atherosclerosis and Lipoprotein Retention Hypothesis (31:18)
- Epidemiological Changes in Health and Cardiovascular Profiles (55:06)
- Concerns about the Keto Diet and Elevated ApoB Levels (58:26)
- Approaches to Managing Elevated LDL Levels Clinically (01:01:13)
- The Role of Evidence-Based Medicine in Cardiovascular Guidelines (01:07:15)
- Comparing ApoB and LDL Cholesterol in Cardiovascular Risk (01:14:36)
- Understanding Discordance in Lipid Measurements (01:18:36)
- Advanced Imaging Techniques for Risk Assessment (01:25:50)
- Guidelines and Considerations for Statin Therapy (01:44:30)
- Coronary Artery Calcium Score, Stroke Risks, and Carotid Ultrasound (01:54:03)
- Dietary Interventions and Carotid Intima-Media Thickness (IMT) (01:59:22)
- Case Study: Family History’s Role in Cardiovascular Risk (02:05:05)
- Overview of Statins, PCSK9 Inhibitors, and Other Lipid-Lowering Therapies (02:12:24)
- Aspirin Therapy and Imaging in Cardiovascular Health (02:26:06)
- Setting Treatment Thresholds Based on ApoB Levels (02:39:57)
- Closing Thoughts on Cardiovascular Risk and ApoB (02:44:16)
Thank you to Dr Dan Soffer for joining me and sharing his expertise on ApoB testing and preventive cardiology. His practical insights provide valuable tools for improving heart health, and I truly appreciate his dedication to patient care and preventive medicine.
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More about Dr Dan Soffer
Dr Soffer is a full-time clinician and educator Associate Professor of Clinical Medicine in the Associated Faculty of the Perelman School of Medicine at the University of Pennsylvania in the Department of Internal Medicine and Division of Translational Medicine and Human Genetics. He is the Director of Education for Preventive Cardiology and Clinical Lipidology at the University of Pennsylvania and co-Director of the Preventive Cardiology Fellowship program at Pennsylvania Hospital and co-director of the SOM Foundations of Culinary Medicine course.
He is a clinical lipid specialist whose focus is Preventive Cardiovascular Medicine. He is a Diplomate of the American Board of Internal Medicine and American Board of Clinical Lipidology, and Fellow of the National Lipid Association (NLA) and American College of Physicians (ACP) and he is a Member of the Academy of Master Clinicians at Penn Medicine.
Dr Soffer’s educational focus is on the impact of atherosclerosis on individuals, the community, and society, and the role of lipids and lipoproteins in this process, along with a special interest in inherited disorders of lipids and lipoproteins. His approach to education is to translate complex science into legible clear language and images that do not require advanced education to understand.
He is involved in multiple education activities at the University of Pennsylvania, the National Lipid Association (NLA), the Philadelphia Lipid and Atherosclerosis Club (PLAC)/Philadelphia Cardiovascular Institute, and commercial continuing medical education as well.
He is involved with multiple NLA activities including leadership, administration, education, meeting planning, and editing. He was President of the National Lipid Association (2023/2024) and President (2018/2019) of the Northeast Chapter of the NLA (NELA). He was co-editor of the NLA journal LipidSpin (2015-2020) and is an Associate Editor of the Journal of Clinical Lipidology as well as co-Director and lecturer for the Foundations of Lipidology course for the NLA. He is also the co-director of the Philadelphia Lipid and Atherosclerosis Club (PLAC). In addition to clinical medicine, teaching, writing, and editing, he also participates as an investigator in ongoing clinical research with lipid-modifying pharmacotherapies and population health initiatives.
He earned BA and MD from the University of Pennsylvania and Internal Medicine residency was completed at the Hospital of the University of Pennsylvania, and has practiced his entire career (since 1997) at Penn.
Dan has been married to Gwen since 1990 and they have three grown children together, Maddie, Ben, and Joe, and one Cavapoo named Petunia.
Supporting studies
- Role of apolipoprotein B in the clinical management of cardiovascular risk in adults: An expert clinical consensus from the national lipid association • PMID: 39256087
