ApoB Testing in Dyslipidemia Management: Knowledge and Practices of Healthcare Providers in Saudi Arabia

Abdulaziz S Altuwalah,1,2 Lama Alfehaid,3– 5 Hussam Alhmoud,6 Alian A Alrasheedy,6 Ibrahim S Alhomoud6 1Pharmacy Services, Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia; 2Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Riyadh, 13713, Saudi Arabia; 3Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 4Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 5King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 6Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, 51452, Saudi ArabiaCorrespondence: Ibrahim S Alhomoud, Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, 51452, Saudi Arabia, Email [email protected]: Apolipoprotein B (apoB), a direct measure of atherogenic lipoprotein particles, is recommended by clinical guidelines for cardiovascular risk assessment, particularly when low-density lipoprotein cholesterol (LDL-C) underestimates risk. Despite these endorsements, apoB testing remains significantly underutilized in clinical practice. This study evaluated the knowledge and practices of physicians and pharmacists in Saudi Arabia regarding apoB testing and its role in lipid management and cardiovascular risk stratification.Methods: Cross-sectional survey-based study conducted with physicians and pharmacists across healthcare institutions using a validated questionnaire.Results: A total of 158 participants completed the questionnaire, including 80 physicians (50.6%) and 78 pharmacists (49.4%). The overall mean knowledge score was 4.70 ± 3.13 (out of a maximum score of 10). Participants specializing in family medicine, cardiology, and ambulatory care had the highest mean knowledge scores among specialties. Physicians demonstrated a significantly higher knowledge score than pharmacists (6.00 ± 2.99 vs 3.36 ± 2.69; P < 0.001). While 69.6% recognized apoB as a direct measure of atherogenic lipoprotein particles, only 53.8% correctly identified it as the most reliable marker of residual atherosclerotic cardiovascular disease risk in patients with lipid profile discordance. A significantly higher proportion of participants with high knowledge reported measuring apoB levels or considering it whenever available in their practice than those with moderate and low levels of knowledge (88.2%, 53.1%, and 24.1%, respectively; P < 0.001).Conclusion: ApoB testing remains underutilized among physicians and pharmacists in Saudi Arabia despite guideline recommendations. Targeted educational initiatives and national-level strategies are needed to enhance awareness and integration of apoB testing in risk assessment practices.Keywords: apolipoprotein B, atherosclerosis, clinical guidelines, lipoproteins, cardiovascular risk