In this article

What is the Heart & Metabolic Score?

Your Heart & Metabolic Score is a single number from 0 to 100 that summarizes your cardiometabolic health, based on two powerful signals from your bloodwork:

  • Atherogenic particle burden: how many “plaque-forming” cholesterol particles you carry
  • Insulin sensitivity: how efficiently your body handles energy and blood fats

A higher score is better. A score in the upper range means your markers look like those of a lower-risk cardiometabolic profile. A lower score means there’s more room to improve in the areas that drive long-term heart and metabolic risk.

It’s designed to be easy to understand, easy to track over time, and tightly focused on the health domains that matter most for long-term cardiovascular and metabolic risk.

If you’ve seen this before as an age:

This score replaces the Heart & Metabolic Age you may have seen previously. It’s built on the same two markers, but it’s now shown as a score out of 100 instead of an age. The direction is reversed: with the old age, lower was better. With the score, higher is better. Your underlying health hasn’t changed – only the way we present it.

The Heart & Metabolic Phenotype

To give a clearer picture than a single number alone, we also place you on a 2×2 phenotype map based on the same two inputs.

1) Lipid metabolism (ApoB)

ApoB reflects the number of atherogenic (“plaque-building”) particles in your blood, including LDL and other ApoB-containing particles.

  • Lower ApoB = fewer atherogenic particles
  • Higher ApoB = more atherogenic particles

2) Insulin sensitivity (Triglycerides:HDL-C ratio)

The triglycerides-to-HDL-C ratio captures two hallmarks of reduced insulin sensitivity: higher triglycerides and lower HDL-C.

  • Lower ratio = better insulin sensitivity signal
  • Higher ratio = more insulin-resistance–associated pattern

What the four phenotypes mean

  • Optimal: both ApoB and insulin sensitivity look favorable
  • Lipid regulated, insulin resistant: ApoB looks favorable, but the ratio suggests reduced insulin sensitivity
  • Lipid dysregulated, insulin sensitive: insulin sensitivity looks favorable, but ApoB suggests elevated atherogenic particle burden
  • Lipid dysregulated, insulin resistant: both signals suggest higher heart and metabolic risk

This map helps you understand whether your focus should be on lipids, metabolic health, or both. Your score tells you how much room there is to improve; the phenotype tells you where to start.

How the Heart & Metabolic Score is Calculated

Each of the two markers is rated on how far it sits from an optimal range. Those two ratings are then combined into one overall picture of cardiometabolic risk, and that is expressed as a score out of 100.

Two things are worth understanding about how they combine:

A strong result in one area doesn’t cancel out a concerning result in the other. The score isn’t a simple average. If one of the two markers is meaningfully elevated, that carries real weight in your score even when the other looks excellent because atherogenic burden and insulin resistance each contribute independently to long-term risk.

Your age is not part of the calculation. Two people with identical bloodwork receive the same score regardless of how old they are. The score describes your markers, not your markers relative to your age group.

Both markers are needed to produce a score. If a panel measures only one of them, no Heart & Metabolic Score is shown for that test.

How to interpret your score

Higher scores mean your ApoB and insulin-sensitivity markers look like those typically seen in lower-risk cardiometabolic profiles.

Lower scores mean your markers look more like patterns commonly associated with higher cardiometabolic risk, which is a useful prompt to focus on improvement and to talk with your healthcare provider.

As with any health score, the most useful insight comes from the trend. A single result is a snapshot. If you’ve tested more than once with both markers measured, you can view your score over time directly on the card in your portal. Testing under similar conditions each time makes those comparisons far more meaningful.

If your score moves, the phenotype map is the fastest way to see why, whether the change came from your lipid particles, your insulin sensitivity, or both.

Why this matters

Cardiometabolic health isn’t just one factor among many – it’s foundational. Atherosclerosis and insulin resistance are among the strongest predictors of long-term disease risk, and both are meaningfully influenced by modifiable factors like diet, exercise, sleep, and stress.

The Heart & Metabolic Score distills these dynamics into a single, trackable number. Instead of interpreting several markers in isolation, you get a clear summary of where you stand and whether you’re trending in the right direction.

Important notes and limitations

  • This is not a diagnosis and does not replace professional medical advice, diagnosis, or treatment.
  • Triglycerides, and therefore the triglycerides/HDL-C ratio, can shift with recent meals, alcohol, illness, disrupted sleep, and recent intense exercise. For the cleanest comparisons, test under similar conditions each time.
  • Medications and supplements, especially lipid- and glucose-related therapies, can meaningfully change these markers, often for the better. This is expected and reflects real improvement.
  • The score reflects two specific signals, not your complete cardiovascular picture. It is intended to sit alongside the rest of your results and your Heart & Metabolic Assessment, not to replace them.
  • At the highest levels of risk, the score levels off. Very elevated markers are all reflected as high risk, so the score is best used to track direction and improvement rather than to grade severity at the extreme end.