You may have had your cholesterol levels checked, but did you know that you can also check your genetic risk for developing heart disease? Separate from the cholesterol panel, this test, known as lipoprotein (a), gives insight into how your genetic makeup affects your heart health.
What Is Lipoprotein (a)
Lipoprotein (a) is a genetically determined risk factor for developing heart disease. Commonly abbreviated Lp(a), it is used to predict one’s risk of stroke, heart attack, or other cardiovascular events.
Lipoproteins are particles made of proteins and fats that carry cholesterol through your bloodstream. The two main types of lipoproteins are LDL (low-density lipoprotein) and HDL (high-density lipoprotein). Lp(a) is a type of LDL cholesterol, often called “bad cholesterol.”
Lp(a) particles are stickier than other types of LDL, making them more likely to adhere to your arteries. This accumulation contributes to plaque buildup, also known as atherosclerosis. The plaque buildup causes the arteries to narrow, limiting the blood supply to the heart. A piece of plaque can break free and block blood flow to vital organs. This occurrence may lead to a cardiovascular event, such as a stroke, heart attack, or peripheral artery disease.
Determining Lp(a) Levels
A simple blood draw can determine your Lp(a) level. This is a specific test your medical provider will order, not covered on a standard lipid panel.
A value greater than 50 mg/dl is considered high. Any number over 50 mg/dl increases one’s risk of developing a cardiovascular condition. Elevated Lp(a) levels also increase inflammation and blood clotting, negatively affecting heart health.
LDL and Lp(a) are both a type of cholesterol but differ in composition. You may have a normal LDL number but an elevated Lp(a) level. It’s important not to forego the Lp(a) test because you have a normal LDL value. If a significant portion of your LDL is carried by Lp(a), your risk for developing heart disease may remain high.
There are no symptoms associated with an elevated Lp(a) level. A healthy lifestyle does not preclude one from having an elevated level because it is an inherited condition. Certain conditions, such as diabetes and chronic kidney disease, may increase your number.
Consider getting your Lp(a) tested if you meet any of the following criteria:
You have a family member who has high Lp(a) levels
You have a family history of cardiovascular events at a young age (younger than 45 for men and 55 for women)
You have a family history of elevated LDL levels, also known as familial hypercholesterolemia (FH)
Managing High Lp(a) Levels
Since Lp(a) levels are determined by genetics, lifestyle modifications such as diet and exercise may not change the value. Similarly, no prescription drugs have been approved for this condition. However, ongoing research and emerging therapies are underway to find effective treatments.
Managing other risk factors for heart disease, such as lowering LDL cholesterol, remains crucial. Eating a well-balanced, heart-healthy diet and engaging in regular physical activity will promote heart health. Limit alcohol use, quit smoking, and maintain a healthy weight to ensure overall well-being. Regular check-ups with your healthcare provider are crucial to monitor your health.
The Bottom Line
Lipoprotein (a) is an inherited condition not influenced by heart-healthy lifestyle modifications. Testing relatives is recommended if an elevated Lp(a) level is known within a family. Early detection and management can help address other heart health risk factors. Consult your medical provider to understand your risk.
Sources
American Heart Association. (2024). Lipoprotein (a). https://www.heart.org/en/health-topics/cholesterol/genetic-conditions/lipoprotein-a#
Farzam, K., Zubair, M., & Senthilkumaran, S. (2024, February 27). Lipoprotein A. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK570621/
Medline Plus. (2022, August 3). Lipoprotein (a) Blood Test. https://medlineplus.gov/lab-tests/lipoprotein-a-blood-test/ Assessed and Endorsed by the MedReport Medical Review Board