Know Your Heart Health

Your heart could be silently aging years faster than you are — and your annual checkup would never tell you.

Traditional blood testing only checks three numbers when looking at your heart:

• Total cholesterol.

• LDL-cholesterol.

• HDL-cholesterol.

But the real story of your cardiovascular health runs much deeper, and modern blood testing now makes it visible.

What is heart health and why does it matter?

Heart health refers to how well your cardiovascular system, your heart, blood vessels, and circulation, delivers oxygen and nutrients throughout your body.

A healthy heart keeps blood flowing efficiently, maintains stable blood pressure, and supports every organ with the energy it needs to function.

When this system starts to struggle, often due to long-term changes in fats, inflammation, hormones, or metabolism, the effects build up quietly over time. These gradual shifts can stiffen arteries, reduce blood flow, and raise the risk of heart disease or stroke, often without early symptoms.

Understanding your heart health means looking beyond how you feel today, and focusing on the biomarkers that determine how your heart will perform years from now.

Why Traditional Heart Checkups Fall Short

For decades, heart checkups have focused on three markers:

• Total cholesterol

• LDL (“bad”) cholesterol

• HDL (“good”) cholesterol

They’re useful, but dangerously incomplete. These numbers tell you how much cholesterol you have, not how your body handles it.

You can have “normal” cholesterol and still have high cardiovascular risk if your lipid particles, inflammation, or metabolism are out of balance.

It’s like judging your financial health only by your bank balance, without knowing your income, spending, or investments. You’ll see part of the story, not the full picture.

What Should Be on Your Next Blood Test

Apolipoprotein B (ApoB)

What it is: ApoB measures the number of cholesterol-carrying particles that can form plaque in your arteries. Each LDL, VLDL, and Lp(a) particle contains one ApoB molecule.

Why it matters: ApoB is one of the most accurate indicators of cardiovascular risk, it reflects the particles that actually cause damage, not just the cholesterol they carry. In a JAMA 2021 analysis, it predicted heart attack risk 27 % more accurately than LDL alone.

Optimal: Below 60 mg/dL (and below 50 mg/dL if you already have risk factors).

What to do: Reduce saturated fats, eat more soluble fiber, include omega-3s (2–3 g/day EPA + DHA), and move at least four times a week.

Lipoprotein(a) [Lp(a)]

What it is: Lp(a) is an LDL-like particle with an extra protein (apo(a)) that increases clotting and plaque buildup.

Why it matters: About one in five people inherit high Lp(a), and it can triple the risk of heart disease, even with normal cholesterol (Circulation 2022).

Optimal: Below 30 mg/dL.

What to do: Because it’s genetic, focus on managing other risks, keep ApoB and hs-CRP low, maintain a balanced diet, and discuss niacin or emerging RNA-based therapies with your doctor if levels are very high.

Triglycerides and Advanced Ratios

What it is: Triglycerides are fats that circulate in your blood from food and metabolism. Ratios like TG/HDL, TC/HDL, and HDL/LDL reveal how efficiently your body manages energy and sugar.

Why it matters: High triglycerides and low HDL indicate insulin resistance and chronic inflammation, two early warning signs of metabolic and cardiovascular disease (AHA 2024).

Optimal:

• Triglycerides/HDL < 2

• Total Cholesterol/HDL >2.5 - <5-5

• HDL/LDL > 0.6

What to do: Cut back on refined carbs and added sugars, and combine resistance training with low-intensity (zone-2) cardio three to four times a week.

Non-HDL and VLDL Cholesterol

What it is: Non-HDL cholesterol adds up all the cholesterol that can form plaque, including LDL, VLDL, IDL, and Lp(a). It’s a broader, more accurate measure of total “atherogenic load.”

VLDL (very-low-density lipoprotein) is produced by your liver to carry triglycerides. High levels often signal fatty liver or insulin resistance.

Why it matters: High non-HDL means there’s too much cholesterol capable of building up in arteries. High VLDL suggests your metabolism is overloaded, your liver is producing more triglyceride-rich particles than your body can clear.

Optimal:

• Non-HDL < 160 mg/dL (ideal < 125 mg/dL)

• VLDL < 20 mg/dL (ideal <10 mg&/dL)

What to do: Lose 5–10 % of body weight if needed, replace refined carbs with healthy fats (olive oil, avocado, nuts), add light activity after meals, and improve sleep to lower liver fat and VLDL.

The Hidden Side of Heart Health

Some of the most important clues about your heart don’t even come from cholesterol at all.

They come from how your body handles inflammation, energy, and repair, silent processes that reveal whether your system is thriving or under stress.

Hs-CRP: Your Body’s Smoke Alarm

Detects low-grade inflammation that accelerates plaque formation and aging.

Optimal: < 1 mg/L

Fasting Insulin and Glucose

Show how hard your body works to keep sugar stable. Elevated insulin is often an early sign of insulin resistance and raises both VLDL and ApoB. Optimal:

• Glucose >74 - <106 mg/dL

• Insuline >5 - <25µIU/mL

Homocysteine

A metabolic by-product that can stiffen arteries if B-vitamin levels are low.

Optimal: >3.7 - < 10 µmol/L

Wearable data that tracks your heart health

Your blood tells one part of the story — but your wearable data tells the other half.

Devices like Apple Watch, WHOOP, Oura, and Garmin now provide continuous insights into your heart’s day-to-day behavior:

• Resting Heart Rate (RHR): A lower, consistent RHR indicates a stronger, more efficient heart. Rising trends over time can signal stress, fatigue, or overtraining.

• Heart Rate Variability (HRV): Measures how adaptable your nervous system is. Higher HRV generally reflects better recovery and cardiovascular resilience.

• Sleep Stages & Recovery: Deep and REM sleep are when your body repairs tissues and balances hormones that affect heart health, like cortisol and insulin.

• Activity & Movement Patterns: Daily steps, active minutes, and recovery days reveal how well your metabolism and circulation are functioning over time.

Holo integrates your wearable data automatically, so every test result is contextualized by how your heart performs every day.

What Can You Do to improve your Heart Heatlh?

Nutrition

What you eat directly shapes how your blood lipids, inflammation, and metabolism behave.

A diet built on whole foods, fiber, healthy fats, and omega-3s supports optimal ApoB and lowers inflammation (CRP).

Limit ultra-processed foods, refined sugars, and excess alcohol, which raise VLDL, triglycerides, and liver fat over time.

Think in terms of balance, not restriction: focus on food quality, regular meals, and nutrient diversity.

Movement

Your heart thrives on consistency, not intensity.

Aim for at least 150 minutes of moderate activity per week, like brisk walking, cycling, or swimming, to lower ApoB by up to 10 % and improve vascular health.

Add strength training 2–3 times per week to raise HDL cholesterol, improve insulin sensitivity, and maintain lean muscle mass.

If you track activity with a wearable:

• Daily steps: aim for 8,000–10,000 per day for optimal cardiovascular and metabolic benefit

• Zone 2 cardio: maintain your heart rate at roughly 60–70 % of max HR (around 120–140 bpm for most adults) for at least 90 minutes per week

• VO₂ max: strive to keep it above 40 ml/kg/min (men) and 35 ml/kg/min (women) — higher values predict better longevity and heart resilience

Even small bursts of daily movement, walking after meals, taking stairs, standing breaks, have measurable effects on triglycerides, glucose regulation, and inflammation.

Sleep and Stress

Recovery is where regulation happens.

Poor sleep raises cortisol, insulin, and inflammatory markers, all of which influence heart health.

Your wearable data helps reveal these patterns, spikes in resting heart rate, low HRV, or reduced deep sleep are early signs your recovery is falling behind.

Aim for:

• 7–9 hours of consistent, high-quality sleep per night

• Resting Heart Rate (RHR): ideally below 55 bpm for men and 60 bpm for women (lower indicates better cardiovascular fitness)

• Heart Rate Variability (HRV): above 60 ms in adults under 40 and 50 ms in older adults — higher reflects better recovery and stress balance

• Deep Sleep: at least 20–25 % of total sleep time

Build routines that help your body unwind. Mindfulness, stretching, breathing exercises, or simply disconnecting from screens before bed.

Genetics

Some factors, like Lipoprotein(a) or familial cholesterol patterns, are inherited and don’t change with lifestyle, but they can be managed once identified.

Testing once gives you a baseline for life. Knowing your genetic profile lets you personalize your nutrition, exercise, and medical follow-up to offset what you can’t change.

Hormones and Recovery

Your hormones set the rhythm for metabolism, energy, and lipid regulation.

Thyroid function, sex hormones, and vitamin D levels all influence how your body produces and clears cholesterol.

Addressing deficiencies, supporting recovery, and maintaining hormonal balance can improve lipid levels, energy, and long-term cardiovascular resilience.

Frequently Asked Questions About Heart Health Testing

Can you have heart disease with normal cholesterol?

Yes. Up to 70 % of heart-attack patients have “normal” LDL (ScienceDaily 2009). Elevated ApoB or inflammation (hs-CRP) often explains why.

Why are heart health ratios relevant?

Low TG/HDL and high HDL/LDL suggest efficient fat metabolism and lower risk.

If your ratios shift, review diet, sleep, and stress before symptoms develop.

What if my markers are slightly out of range?

Small deviations aren’t cause for panic, they’re opportunities to act early.

Track them over time and focus on consistent habits rather than single results.

How important is heart health for my daily life?

Your cardiovascular system powers everything: energy, focus, recovery, even sleep quality.

A healthy heart means a longer, stronger, more vibrant life.

Ready to understand your heart?

We’ve built Holo for your heart. So you can keep loving others and being loved.

Measure ApoB, Lp(a), triglyceride ratios, and hs-CRP in one test.

Get clinician-reviewed insights you can act on.

Track your progress through the Holo app and your wearables.

Get your heart health tested at tryholo.com

Because every beat matters.

References

European Society of Cardiology (2023) — Dyslipidemia Guidelines

JAMA (2021) — ApoB vs LDL for Risk Prediction

Circulation (2022) — Lp(a) and Atherosclerosis

Nature Medicine (2023) — Inflammation and Preventive Cardiology

American Heart Association (2024) — TG/HDL Ratios and Metabolic Health

Science Daily (2009) - Most Heart Attack Patients' Cholesterol Levels Did Not Indicate Cardiac Risk