Ladd McNamara, M.D discusses the future of medicine both as it relates to health, supplementation, and how health professionals are finding new ways to increase income in an ever evolving world!

Oxidized LDL Cholesterol is the Best Predictor of Heart Disease

Previously, I blogged about Oxidized LDL Testing, but this blog post is dedicated to opening your eyes as to the correlation of oxidized LDL cholesterol to coronary artery disease (heart disease).

As I travel to various cities speaking on the Power of Cellular Nutrition, and conduct webinars on nutritional supplement products that can truly make a difference in one’s health, I always bring up the concept that it is NOT the mere (traditional) LDL cholesterol level that most people have tested that determines whether one is at risk for heart disease, it is the level of OXIDIZED LDL CHOLESTEROL which shows the true correlation to heart disease.

I have taught this concept about oxidized LDL cholesterol being more correlated to one’s risk of heart disease than their absolute LDL cholesterol levels, for over 15 years now, and wrote about it in my book, The Cholesterol Conspiracy. I have cited the numerous medical studies supporting this fact, but still mainstream medicine clings on to the false idea that it is all about one’s LDL cholesterol level, or cholesterol ratios. I think the drive to keep this misconception, or out-right falsehood going is the pharmaceutical companies that make billions off of you believing you need to be on a cholesterol-lowering statin drug if your LDL cholesterol is too high, or if you’re diabetic, …or, if you’ve had prior heart attacks.

Although, I must say that you “need to check with your doctor” before embarking on a nutritional supplement program, and “never change your medication without talking to your doctor,” the sad fact is most medical doctors do not have any idea that they are being deceived by pharmaceutical companies that twist the facts to sell more statin drugs. And, for what …to lower your LDL cholesterol? To reduce your risk of death?

Why, can anybody even state HOW, that is the mechanism of why statin drugs have even been shown to have a SLIGHT reduction in cardiac deaths? And, here’s a hint, it is NOT the mechanism of lowering your LDL cholesterol! It is true, they lower LDL cholesterol levels, but that is not the mechanism by which they have been shown to have a slight reduction in deaths. Why, if you knew the truth, you may not need a statin drug at all!

Below are graphs, which illustrate that LDL cholesterol levels are NOT a good predictor of coronary artery disease, and oxidized LDL cholesterol is! For example, see below. What was your last LDL cholesterol level? How protected from heart disease and stroke do you think you are? Even among patients that had a very low LDL cholesterol level (below 108 mg/dl) over 45% still developed heart disease! And, combine that group, with patients with LDL cholesterol levels between 109 and 129 mg/dl, you can easily see that over 50% of the patients with a LDL cholesterol below 130 mg/dl still have heart disease.

Relationship Between LDL Cholesterol and Coronary Artery Disease

This alone should put an end to people thinking that if they have a low LDL cholesterol that they are “safe” from heart disease, because a LDL Cholesterol Level is NOT a good predictor of your risk for heart disease! It is the Oxidized LDL cholesterol, and more rightfully, your oxidized LDL-to-HDL ratio that you should know.

Here is the graph for your Oxidized LDL cholesterol. See how it is linear? This means, the lower your oxidized LDL cholesterol the lower your risk of heart disease, and vice versa. It is a VERY GOOD predictor of heart disease. You could have a low absolute level of LDL cholesterol (on the above green chart) and feel very comfortable in your assumed safety, but be at extreme risk of heart disease because you have a high OXIDIZED LDL CHOLESTEROL level.

Relationship of Oxidized LDL to Coronary Artery Disease

And, Who is telling you about this, and who is testing for this? Moreover, what how do you bring down your oxidized LDL cholesterol level, and are you doing enough?

You are told about LDL cholesterol, HDL cholesterol, cholesterol ratios, etc., but not about the importance of oxidized LDL cholesterol. Do the makers of cholesterol-lowering statin drugs know about this? Absolutely! They know about this, and even know that statin drugs slightly lower oxidized LDL cholesterol, and in fact, THAT IS THE MECHANISM by which they help lower heart disease and inflammation. They have a slight anti-oxidant, anti-inflammatory effect that helps lower oxidized LDL cholesterol (regardless of what your true LDL cholesterol level is).

So, statin drugs work, right? Well, they do …slightly! They will lower your LDL cholesterol level, and that is what you see on your test. What you don’t see is that they will slightly lower your oxidized LDL level, which is vastly more important. Again, I don’t care what someone’s absolute LDL cholesterol level is, I don’t care if it is high or low, because ultimately that does not matter as much as their OXIDIZED LDL CHOLESTEROL and their HDL CHOLESTEROL LEVELS.

Why would pharmaceutical companies not tout this concept of statin drugs lowering your oxidized LDL cholesterol? Because then you would know their dirty little secret: that ANTIOXIDANT SUPPLEMENTS do a MUCH BETTER JOB at LOWERING OXIDIZED LDL CHOLESTEROL and RAISING HDL CHOLESTEROL, along with diet and exercise, than statin drugs could ever do. They don’t want you to understand this, because then you could take matters into your own hands and drive down your risk of heart disease without them!

Nina Johnston et al, in the American Journal of Cardiology (March 2006) documented that the oxidized LDL-to-HDL cholesterol ratio test is a superior blood lipid test to identify risk among apparent healthy men and women. This graph shows that every patient should be tested for their oxidized LDL-to-HDL cholesterol ratio. You want your oxidized LDL cholesterol as low as possible, and your HDL cholesterol as high as possible. This gives you the best chance of avoiding heart disease and stroke.

Relationship of oxLDL-to-HDL Cholesterol Ratio and Coronary Artery Disease


If you get this concept, you will truly know the most important blood testing you could possibly obtain and work to improve, if necessary, than anything your doctor or pharmaceutical companies could ever tell you. (But, be sure to talk with your doctor about this information, especially don’t make any changes to your medications without such a discussion. I’m sure he or she will be on board with all this information.)

You must know this. If you have high LDL cholesterol you must do something about it, BECAUSE, there is more LDL cholesterol, particularly certain sub-fractions (Lipoprotein A, etc.) that are highly susceptible to oxidation. There are other tests out there saying that they test your true risk of heart disease by testing the LDL cholesterol particles that are associated with heart disease. The question I ask is, WHY are these LDL particles associated with heart disease? Because they are the ones that are most easily OXIDIZED! Has anyone figured this out?

Therefore, eat a healthy diet, exercise regularly, keep your weight down, avoid trans fats (as they oxidize your LDL cholesterol), and take a healthy, safe, full-range of vitamins, minerals, antioxidants, and omega-3 fatty acids (fish oil), as this is the way to true health. This is what lowers your oxidized LDL cholesterol (no matter what your absolute LDL cholesterol level is), and it helps to raise your HDL cholesterol, and it all helps to reduce arterial inflammation.

Testing Your Oxidized LDL Status

I suggest the “Triple Marker test” from Shiel Medical Laboratory in New York, for assessing your oxidized LDL cholesterol state and cardiovascular risk status.

Other Fun Facts:

Over 1/3 of all individuals who developed Coronary Artery Disease (CAD) in the Framingham Study were NOT identified through standard lipid testing! Their LDL cholesterol levels did not predict the incidence of CAD. Current data suggests that some of those patients at risk could be identified with oxLDL testing, thus enhancing our ability to predict who is truly at risk for CAD.

Obese and diabetic patients most often have increased blood levels of oxidized LDL cholesterol. Using the OxLDL-to-HDL cholesterol ratio test may assist in the determination of a reasonable therapeutic intervention (diet, exercise, supplementation, etc.)

Increased concentrations of oxLDL may indicate an increase in atherosclerotic plaque, which leads to a greater risk of CAD. The oxLDL-to-HDL cholesterol ratio test is an important tool for overall cardiac health evaluation.



A 2012 Spanish study of 75 patients with either high cholesterol or diabetes and on a statin drug, along with a secondary risk factor, such as diabetes, smoking, or obesity were followed in a triple-armed, controlled study for 6 months.   One group took a placebo, a second group took 350 mg of grape seed extract daily, and a third group took both 350 mg of grape seed extract and 8 mg of resveratrol (from the red grape as well) per day.   After 6 months, the grape seed extract only group lowered their LDL cholesterol level by 2.9%.   Not that big of a deal, but something.

Of greater interest to me was the group that took the combination of 350 mg of grape seed extract and 8 mg of resveratrol decreased their LDL cholesterol levels on average by 4.5%  (and ApoB by 9.8%),  …and most applicable to my article here, they reduced their OXIDIZED LDL CHOLESTEROL levels by an average of 20%!!!    Now, we’re seeing the benefits of synergistic action of antioxidants.

I now suggest that in addition to a foundation of high-quality nutritional supplements (of multi-antioxidants, chelated minerals, and pharmaceutical-grade fish oil), that people consider take at least 400 mg of a quality grape seed extract, along with 30 mg of resveratrol (often found in an antioxidant booster with grape seed extract) each and every day.
The Cholesterol Conspiracy is now available in audio book form, downloadable from iTunes and Audible. Click on image of book above to be directed to iTunes. Thank you.

1. Am J Cardiol. 2006 Mar 1;97(5):640-5.
2. Diabetes 60 doi:10.2337/db09-1455 (2011)
3. Am J Cardiol. 1995 Jun 15;75(17):1189-95
4. Arch Intern Med. 2001 Dec 10-24;161(22):2685-92
5. Lancet 2001 Dec 15;358(9298):2026-33

Addendum reference:

6.  Tome-Carneiro J, Gonzalvez M, et al.  Consumption of a grape extract supplement containing resveratrol decreases oxidized LDL and ApoB in patients undergoing primary prevention of cardiovascular disease: A triple-blind, 6-month follow-up, placebo-controlled, randomized trial.  Mol. Nutr. Food Res. 2012, 56, 810–821

Medical Disclaimer- Everything on this website, and in this article, is not to be interpreted as, or substituted for, medical advice.  It is for informational purposes only, to be used to faciliate a conversation with your health care provider.  Please consult with your own personal health care provider before embarking on a supplement program.   The information on this website is not meant to take place of the information and recommendations you receive from your personal physician or other licensed health care provider, as the information and considerations offered on this website may not apply to your health condition and needs.   Do not use any information on this website for the use of diagnosing, treating, or managing your care without a thorough discussion with your health care provider.   Do not stop, start, or change any medication without consulting with your physician.   If you have, or suspect that you have, a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this website.  Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.


Posted On
May 07, 2012
Posted By

Thanks for breaking down the releavance between LDL and oxidized LDL. I’ve heard you speak on other occasions and seen your visual aid where the Oxidized LDL gets “sticky” and adheres to the arterial wall that’s been scaring from Homocystine. Could you also address what elevated levels of Homocystine can do?

You can probably attest to the fact that so many of our medical professionals are getting trained by professional pharmaceutical sales reps on what’s good for our bodies and ailments. Sadly it’s primarily driven by revenues and not based on sound research.

Posted On
May 07, 2012
Posted By
Ladd McNamara, M.D.

Thank you Jim. I appreciate that. I did write about homocysteine (see Category “Labwork”) on this blog; and have more on homocysteine at And, your assessment is correct. Thank you.

Posted On
May 07, 2012
Posted By

This is a very imformative article. is there a specific name for the oxidized ldl nlood test, can we obtain this test on our own without seeing a doctor through an online lab?

Posted On
May 07, 2012
Posted By
Ladd McNamara, M.D.

You always need a doctor’s order for lab work to be done (even online labs use a doctor to order the tests). There is a lab that I recommend, and they have a doctor that can place the order for a small fee. Please contact Molly Fini (the lab rep) at to request information about the “specialty cardiac panel” (which includes the regular cardiac tests and the oxidized LDL-to-HDL cholesterol ratio, vitamin D, homocysteine, etc.).

Posted On
Jun 14, 2012
Posted By
Bill Talllman

Thank you Ladd for making the cholesterol issue so clear. Every since I read your book on cholesterol (The Cholesterol Conspriacy) I have been using your information in my seminars with great results. It is good to see so many people waking up to the reality of the “statin drug game” and getting onto high level antioxidants to counteract free radical damage. We are very fortunate to be affiliated with a world leader in cellular nutrition and to be able to change lives, and we all thank you for your contribution to what I feel is the greatest cause on the planet.

Posted On
Dec 05, 2012
Posted By
Mohamed M Gani

Dr. Nawab at UCLA did excellent work on ox-hdl and I did meet him on several occasions to discuss his theory on ox-lipids. My interest was also ox-lipids and we did make a large panel of monoclonal antibodies against all forms of ox-lipids(hdl,ldl,has, etc). I have retired now but agree with what you are saying. There should be such tests available for cardiologists to compare results on both type of tests.

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Information on this web site is provided for informational purposes only. The information is a result of years of practice experience and study by the author. This information is not intended as a substitute for the advice provided by your physician or other healthcare professional or any information contained on or in any product label or packaging. Do not use the information on this website for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this web site. Information provided on this web site and the use of any products or services purchased from this website (or as a result of information provided this website) by you DOES NOT create a doctor-patient relationship between you and any of the physicians or authors affiliated with this website. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.