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The several apolipoproteins have key roles in lipid metabolism, the immune response and cell membrane function. There is recent controversy as the best predictor of coronary heart disease amongst lipoproteins and lipids is unclear and measuring lipids is cheaper. While it has been reported that the assays for apo B and apo A1 are no better predictors of coronary heart disease than the traditional total cholesterol to HDL cholesterol ratio[1] the INTERHEART study has now done a large international comparison which showed that non-fasting ApoB/ApoA1 ratio was superior in all racial groups, sexes and ages in predicting the risk of acute myocardial infarction[2]. The arguments are likely to now relate more to cost effectiveness and the difficulty in convincing a generation that cholesterol measurements are not the be all and end all of addressable cardiovascular risk.