People take cholesterol lowering medications to decrease their risk of heart disease and yet many people with optimal cholesterol levels are still having heart attacks and strokes. Why can heart attacks strike people who seem to have the perfect levels? Cue this little known risk factor, lipoprotein (a), aka lp(a) also called lipoprotein little a.
Lp(a) is a type of LDL cholesterol but with a protein coiled around it called apolipoprotein (a). You can be born with these Lp(a) particles so they are considered to be a genetic risk factor. People with elevated Lp(a) are at risk for heart disease and therefore heart attack at an earlier age even though their other cholesterol levels are NORMAL! This means even with optimal levels of LDL you can still be forming plaque! READ ON to learn more about this important marker for prediction of heart disease….
Here is what you need to know about Lp(a)
- Lp(a) is coded in your genes. Thanks mom, thanks dad. You are literally born with this predisposition.
- Diet and exercise really don’t change the amount of Lp(a) you have, but you should still pursue health eating and exercise to keep other additive factors from making the plaque forming ability even worse.
- You can have a high Lp(a) despite having a very low LDL and still be at risk for plaque formation
- Lp(a) measurements vary by the lab. The most accurate level is reported in nmol/L which indicates the number of particles of Lp(a) vs the mg/dl version which indicates the total mass of the particles. There is value in both tests though.
- The risk of heart disease starts to rise when your levels are higher than 30mg/dl (75nmol/L) and the risk escalates when levels are above 50mg/dl (125 nmol/L).
- There are no prescription medications that target lowering Lp(a). In fact, some of the cholesterol lowering medications actually increase this level!
- Natural treatments for decreasing Lp(a) include niacin, bergamot as well as a procedure called apheresis. Even then, with the exception of apheresis, the amount of decrease of Lp(a) is limited with these treatments.
I usually recommend checking Lp(a) at least once if you have high cholesterol or a family history of heart disease or stroke. The number really doesn’t change much so I don’t usually follow it once I know you either have an elevated number or not. When you have high Lp(a) the target goal of LDL is less than 70 and more recent literature in some areas is targeting an LDL of 50. This is a huge difference from a “normal” LDL of less than 100!!
If you have a family history of heart disease, have heart/carotid disease yourself at a younger age or have high cholesterol then you need to screen for this test at least once!
To your health,