What should my ApoB be?
Under 90 mg/dL (0.90 g/L) if your doctor puts your heart risk at borderline or intermediate, under 70 at high risk, and under 60 if you’ve had a heart attack, stroke, stent or bypass. These come from the National Lipid Association’s 2024 table, which matches ApoB to the LDL goals in the 2026 US guideline. At low risk there’s no number goal.
What we’d do
Find out your risk band first. Ask your doctor for your PREVENT score, the 10-year risk the 2026 guideline uses. If you don’t know it yet, hold your ApoB against under 90. And don’t let your age move the goal. ApoB tends to creep up through young adulthood, and the goals stay where they are.
- Under 60 very high risk
- Under 70 high risk
- Under 90 borderline or intermediate risk
- 120 raises risk
- 140 severe
mg/dL over g/L. Rungs from the National Lipid Association (2024), matched to the 2026 US guideline's LDL goals. Ticks from the 2026 guideline.
| Which fits you | ApoB goal | Matched LDL goal |
|---|---|---|
| Heart attack, stroke, stent or bypass | under 60 mg/dL0.60 g/L, or under 70 (0.70) if your doctor says you're not at very high risk. With FH, the guideline's own number is under 55 once your LDL goal is met | under 55 mg/dL |
| Diabetes, 40 or older | under 90 mg/dL0.90 g/L, or under 70 (0.70) if your doctor puts your 10-year risk over 10% | under 100 mg/dL |
| High 10-year risk (10% or more) | under 70 mg/dL0.70 g/L | under 70 mg/dL |
| Borderline or intermediate risk (3 to under 10%) | under 90 mg/dL0.90 g/L | under 100 mg/dL |
| Low risk (under 3%) | No number goal, healthy habits |
ApoB goals from the National Lipid Association's 2024 table, matched to the 2026 US guideline's LDL goals. The guideline's own lines: 120 or more raises risk, and 140 or more is severe high cholesterol, a doctor visit at any risk.
Where these numbers come from
The 2026 US guideline sets its goals in LDL and non-HDL. The National Lipid Association (NLA), one of the groups that wrote the guideline, worked out the ApoB that goes with each one. Its researchers took the national health survey and two big drug trials, and asked what ApoB people typically had at each LDL goal.
At an LDL of 55, 70 and 100, the typical ApoB was 62, 73 and 94 in people on treatment, and 53, 63 and 83 in people who weren’t. They averaged each pair and rounded to the nearest number ending in zero. That’s how you get 60, 70 and 90.
| Risk | LDL goal | Non-HDL goal | ApoB goal |
|---|---|---|---|
| Very high | under 55 | under 85 | under 60 |
| High | under 70 | under 100 | under 70 |
| Borderline or intermediate | under 100 | under 130 | under 90 |
The guideline’s own ApoB lines
The guideline’s text names four ApoB numbers of its own, shown as ticks on the ladder above:
- Under 55, for people with heart disease and severe high cholesterol, once their LDL and non-HDL goals are met.
- Under 100, paired with an LDL under 100, for someone with a coronary calcium score of 1 to 99.
- 120 or more is on its list of things that raise risk.
- 140 or more is severe high cholesterol, at any risk.
With diabetes and age 40 or more, the goal is under 90, or under 70 if your doctor puts your 10-year risk over 10%.
What nobody has tested yet
Every cholesterol outcome trial so far enrolled people by their LDL, not their ApoB. The NLA says the same approach “is not possible with apoB because the completed RCTs were not designed using apoB entry criteria”. The ApoB goals are translations of LDL goals that trials did test. We think that’s a sound way to set them, since when the two numbers disagree, heart risk follows the ApoB.
It’s like a recipe written in cups that someone converted to grams. The conversion is careful, but nobody baked the cake again in grams.
3 sources
- Soffer DE, Marston NA, Maki KC and others, Role of apolipoprotein B in the clinical management of cardiovascular risk in adults: an Expert Clinical Consensus from the National Lipid Association, Journal of Clinical Lipidology, 2024pmc.ncbi.nlm.nih.gov
- Blumenthal RS, Morris PB, Gaudino M and others, 2026 ACC/AHA guideline on the management of dyslipidemia, JACC, 2026doi.org
- The same guideline, full text, Circulation, 2026api.iscpcardio.org
