VAP stands for vertical auto profile, and it tests cholesterol measurements more specifically than previous cholesterol tests. Jere Segrest, a scientist at the University of Alabama in Birmingham, developed the VAP test. In 1999, a company called Atherotech, also located in Birmingham, was formed. Atherotech patented the VAP test and is currently the only company with rights to produce it.

Previous blood cholesterol tests examined the levels of high density lipoproteins (HDL), also called “good cholesterol.” These tests also examined and counted the presence of low density lipoproteins (LDL), or “bad cholesterol.” These earlier tests were roughly 40% accurate in predicting risk for heart attack.

What scientists discovered while developing the VAP test is that HDL and LDL could be broken down further into subtypes by reclassifying density. These subtypes could further define cholesterol levels and risk of heart attack. High levels of LDL are considered to increase risk for heart attack and necessitate treatment. The VAP test expands on this knowledge. It examines a subtype of LDL called Lp(a), which, when it is the predominant form of LDL, can increase the risk of heart attack up to 25 times.

High levels of HDL were once considered to mean a reduced risk of heart attack. However, HDL is further classed into subtypes, HDL1 and HDL2. While either type of HDL reduces risk, the VAP test measurement separates the two types of HDL. HDL2 is far superior to HDL1, providing more protection for the heart.

The scientists at Atherotech believe that understanding these subtypes can more than double the ability to predict heart attack. Their material has been supported by data from clinical trials at both the University of Alabama and Richmond Medical College. In fact, one aspect of the study at Richmond Medical College, using the VAP test for diagnostics, showed that people with low levels of HDL2 were at a greatly increased risk for abnormally young heart attack.

Most insurance companies recognize studies supporting the VAP test. Virtually all health insurance companies and Medicare pay for the VAP test. However, since the test is relatively new, a patient may have to request the VAP instead of the standard cholesterol test.

When a person is uninsured, or has insurance that does not cover the VAP test, it can be ordered online. With shipping and handling, it costs about 100 US dollars (USD). A lab or doctor’s office must administer the VAP test, but it is a simple blood test, much like the previous test for cholesterol. Most labs already have the VAP test on hand, or Atherotech’s website can guide you to a site or doctor that administers the test.

If one has a family history of high cholesterol or early heart attacks, the VAP test may be particularly helpful in diagnosing early problems, like the lack of enough HDL2 or the presence of far too much Lp(a). It may significantly improve medical treatment for controlling cholesterol levels long before they affect the heart.