Which lipoproteins are associated with a higher risk for heart disease?

• A. HDLs
• B. LDLs and VLDLs
• C. Chylomicrons only
• D. All lipoproteins are equally risky

Answer: (B)

The main idea is that certain lipoproteins drive the buildup of cholesterol in artery walls, increasing heart disease risk. LDL particles deliver cholesterol directly to cells in the arteries, and when they’re abundant or become oxidized, they’re taken up by macrophages and form foam cells that start and fuel plaque formation. VLDL carries triglycerides, and its remnants can also contribute to atherogenesis; after processing, VLDL can become LDL, continuing the cycle of cholesterol-rich plaques. Chylomicrons mainly transport dietary fats after meals and are cleared quickly, so they’re not a major driver of atherosclerosis in the usual picture. HDL, in contrast, helps remove cholesterol from arteries and has protective effects. So the lipoproteins linked with higher heart disease risk are the LDLs and VLDLs.