Lipoprotein a (or Lp(a)) is an independent risk factor for cardiovascular diseases. This is different from the low-density lipoprotein cholesterol (LDL-cholesterol or commonly known as the “bad cholesterol”).
What is this Lp(a)?
- It is a lipid particle that is structurally similar to the common “bad cholesterol”(LDL-cholesterol). These Lp(a) particles can stick to the walls of the artery causing inflammation and plaque build- up.
- Studies have shown Lp(a) particle have stronger association with heart artery diseases and stroke when compared to LDL-cholesterol.
- It is mostly determined by your genetics. Therefore a one -time screen in adulthood will usually suffice. The levels do not change much with exercise or dietary interventions unlike LDL-cholesterol.
- Variation in the LPA gene causes differences in the Lp(a) levels across different ethnic groups. The highest levels are seen in the Black population, followed by South Asians, Whites, Hispanics and East Asians.
Who should get tested?
Most guidelines recommend a one – time screen in adulthood for all. High Lp(a) levels can be seen in almost 1 in 5 people.
How is Lp(a) level measured?
- This is done via a simple non- fasting blood test.
- It is measured and reported either in mg/dL or nmol/L. Levels ≥ 50mg/dL or 125nmol/L are usually used as the cut-off to define high levels.
What should I do if I have high Lp(a) levels?
- There is currently no approved treatment for high Lp(a). There are several medications that have been shown to be effective in significantly reducing Lp(a) levels. These medications are currently being evaluated in large scale clinical studies to monitor the effect on reducing cardiovascular events.
- As it is an independent risk factor for cardiovascular disease and aortic valve narrowing, one should target other existing cardiovascular risk factors for a more stringent control eg improving blood pressure, diabetes control, a stricter LDL-cholesterol target, stopping smoking or weight reduction for overweight patients.
- Consider getting your close family/relatives to go for screening so they too can take active steps in reducing their long- term cardiovascular risk.
While Lp(a) may be lesser known, it is a significant risk factor for cardiovascular disease and heart valve narrowing (aortic stenosis). Knowing your Lp(a) status can lead to a more informed discussion with your doctor on the steps you can take in maintaining health. So, talk to your doctor about Lp(a) screening if you have not already done it.