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Cholesterol LDL sdLDL

Lipoprotein Particle Profiles, Standard Lipids, and Peripheral Artery Disease Incidence

Aaron W Aday, Patrick R Lawler, Nancy R Cook, Paul M Ridker, Samia Mora, Aruna D Pradhan

Circulation 2018

Study Details

Journal Circulation
Year 2018
URL: www.ahajournals.org
1 min read

Table of Contents

Leg artery disease isn’t just about “bad cholesterol”

What is PAD in plain words?

PAD means poor blood flow to the legs. Doctors explain it as: narrowed leg arteries cause pain when walking (claudication), and sometimes you need a procedure to open them.

What did this study find?

  • LDL cholesterol (the usual “bad cholesterol”) didn’t predict PAD well in women.
  • More LDL particles—especially small, dense ones—did predict higher PAD risk.
  • More triglyceride‑carrying particles (VLDL), especially medium and very large, also linked to higher risk.
  • Higher HDL (“good” cholesterol) and more HDL particles linked to lower risk.
  • A higher total cholesterol:HDL ratio strongly tracked PAD risk.

Where does this challenge common beliefs?

Focusing only on LDL cholesterol can miss PAD risk. Particle counts (LDL-P, HDL-P) and triglyceride‑rich particles (VLDL) tell a clearer story for leg arteries.

What to discuss with your doctor

  • What do my LDL, HDL, triglycerides, and TC:HDL ratio say about PAD risk?
  • Would advanced particle testing (LDL-P, HDL-P, VLDL-P) help assess my leg artery risk better than standard cholesterol alone?

Bottom line:

For PAD, it’s not just how much cholesterol—you need to know how many particles, how small they are, and how triglyceride‑rich they are. Relying on LDL-C alone may underestimate risk.