Cut From Steel

He quit four packs a day. His heart sent the bill anyway.

Dwight Eisenhower smoked four packs of cigarettes a day for years. He quit cold turkey in 1949. Six years later he was President of the United States, on vacation in Denver, when his heart gave out.

Eisenhower had a heart attack late in September 1955. He was sixty-four years old. Doctors kept him at Fitzsimons Army Hospital for about six weeks, and the country worried about whether he could carry on.

Eisenhower's heart specialist, Paul Dudley White, then did something new. White stood up at a press conference and explained the attack to the whole country in plain words. He talked about diet, tobacco, exercise, and family history. Millions of Americans learned that a heart attack had causes a doctor could measure. Heart attacks became less mysterious that day.

Eisenhower went to work on his own numbers. He exercised, cut fat from his diet, watched his weight, and had his cholesterol checked. In 1956 he ran again and won 457 electoral votes, an even bigger landslide than his first. He lived until 1969.

You do not need a heart attack to start keeping score. Eisenhower learned the lesson the hard way. He started measuring after the attack. You can start before one. Your first move costs one tube of blood.

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=> See the test doctors stopped ordering..and what they don’t want you to know

The number that came back fine

You had your cholesterol checked last year. The doctor glanced at the sheet and said your LDL looked fine. You walked out relieved and never gave your arteries another thought.

I want you to give them a thought today. Your LDL number measures how much cholesterol rides around in your blood. It does not count the particles carrying it. Those particles are what push into the artery wall and help build plaque.

You can have a normal-looking LDL and still carry too many of them. Cleveland Clinic notes that the test which counts them is not part of a standard lipid panel. Somebody has to ask for it.

Weight versus headcount

You can think of LDL as the total weight of cargo on a highway. ApoB is the number of trucks. Each harmful particle carries exactly one ApoB protein, so one ApoB test gives you a headcount. Research suggests that headcount may predict heart risk better than the standard panel for some men. Three kinds of men should care most.

01 / The man with a belly

You carry weight around your middle, or your doctor has mentioned metabolic syndrome. Cleveland Clinic says men like you often have smaller, denser LDL particles. Your LDL number can look fine while the particle count runs high. That is exactly where the standard panel can give false comfort.

02 / The man with high sugar

You have diabetes, or your blood sugar sits near the top of normal. Cleveland Clinic names diabetes as one of the conditions where ApoB adds information. The usual lipid math is not accurate for everyone, and you may be one of the exceptions.

03 / The man with a family story

Your father had a heart attack at sixty, or your uncle got a stent before he retired. Doctors order ApoB when they want another way to measure risk. That matters most when your standard numbers do not explain your history.

Ask for the headcount

You can ask for this test by name at your next blood draw. Say the words apolipoprotein B. It is a separate test from your cholesterol panel, so ask what it will cost before the needle goes in.

You should know the ranges before the result comes back. Cleveland Clinic lists a typical male range of 66 to 133 mg/dL, and it flags anything above 130 as higher risk. Your doctor may want yours lower, depending on your history.

You can also ask your doctor to read the result alongside your family history and your waistline. One number means more next to the rest of your picture. A man with a big belly and a high count may need a different plan than a lean man with the same count.

I am not telling you to panic over one number. A high result starts a conversation with your doctor. Food, movement, weight, and medication can all move it, and your doctor can tell you which lever matters most for you.

One last thing. Eisenhower got serious about his numbers after his heart forced the issue. Count the trucks now, while the choice is still yours.

— Travis

Insider Member's Corner

6 free habits that keep your arteries in your favor: