What is a VAP Test?

Tricia Christensen
Tricia Christensen

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 test and is currently the only company with rights to produce it.

Blood is drawn to measure cholesterol levels.
Blood is drawn to measure cholesterol levels.

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.

High levels of LDL are considered to increase risks for heart attacks.
High levels of LDL are considered to increase risks for heart attacks.

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.

Consuming red wine may help increase the levels of good cholesterol in the blood.
Consuming red wine may help increase the levels of good cholesterol in the blood.

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.

VAP testing is more accurate than traditional blood lipid profiling methods.
VAP testing is more accurate than traditional blood lipid profiling methods.

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.

A vertical auto profile provides more specific cholesterol measurements.
A vertical auto profile provides more specific cholesterol measurements.

Most insurance companies recognize studies supporting the VAP test. Virtually all health insurance companies and Medicare pay for it. 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 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.

A lab will be responsible for running a VAP test.
A lab will be responsible for running a VAP test.
Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent wiseGEEK contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

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Discussion Comments


Low carb diets full of animal fats usually curb LDLb although total LDL may go up. This is why high fat diets have been demonized. Now that the VAP can make a distinction between low risk/high risk LDL, animal and dairy fats appear to be good for your lipid profile.


My cholesterol was 171 on my last test. However, my LDL was 90. With a new VAP test my Lpa was 69. My doctor felt that 20mg of statin that I have been taking for about 25 years should be good. I have recently been diagnosed with moderate atherolsclorsis in the right leg. I am concerned. What should I do?


There is a lot of misunderstanding of LPa. Berkeley labs standardized the testing and measurement of LPa. Lp(a), Extended Range (mg/dL) LPa range is 0 to 200 with =>30 in the alert range. Look online and check the information for clinicians to get a description of the the tests, then do your own research.

At 107 lbs, 18 percent body fat, female athlete, diet of 20 percent or less fat for over 20 years, my LPa is 186.


A Lp(a) above 10 implies that it has become procoagulant in it's activity. Above it is stated that an Lp(a) of 35 is dangerous. I believe that any value above 10 is an issue, and that it is a qualitative, not quantitative issue re its procoagulant activity. Ever hear of the "widow-maker syndrome"--normal LDL with an elevated Lp(a)?


Does anyone know if you get a VAP test and your high LDL(209) proves to be the large fluffy type, is it still necessary to bring it down according to regular lab value? please help. My M.D. wants to start me on a statin drug without the VAP testing.


LPa (verbalized as LP little a) is a serious contributor to heart and vascular disease when the value is over 30. If you have a high LPa you should also have a homocystiene, hsCRP, plasminogen activator inhibitor I (PAI-1).

the treatment of Lpa is weight reduction, exercise, stop smoking (these apply to all people), niaspan for life, aspirin, for women estrogen or raloxifene can be very helpful in controlling lipid disorders and in male and females fenofibrates can be helpful.

Talk to your doctor and possibly get a referral to a lipid specialist for more information. J.L. Holly, MD


I was wondering does anyone know what kind of treatment is good to lower the LPa? Mine is 33 now. It just seems to be going up. The doctor said to try nisapam, but i tried it for a short time and it did not help so my heart doctor wants me to take it long term.

I just read that in 67 percent of patients, it does not work and that long term use is toxic. I don't know what to do. Before i had Vap my tests were always normal with this Vap lipid. Hope someone has some answers. Thank you.


does this test give also indications about fat in the liver? Do you know of any other test good for that purpose?


Will this test help me decide if my current treatment is not needed (zocor 20mg)? My family history does *not* include heart attack, I quit smoking 17 years ago. Exercise and watch my weight and salt intake. Current cholesterol test was total cholesterol=156, HDL=54, LDL and Triglycerides <100. No other risk factors that I know of. My reason to stop using zocor are the side effects (leg pain/weakness/cramping). Many of the drugs we take for different ailments, the side effects are worse than the disease!



In response to the question about C-reactive protein on the VAP: Atherotech, the diagnostic lab that provides the VAP, also provides both hsCRP and homocysteine, but they not inclusive of the VAP measures which are 15 cholesterol metrics. If you want a hsCRP and/or homocysteine, then the ordering clinician would need to order these tests independent of VAP from Atherotech. I hope this helps answer your question. Best, Atherotech


I have a printed brochure on VAP tests that states that a C-reactive protein test is part of VAP. My VAP results have come back and there is no report on this vital marker of inflammation. What gives?

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