Lipoprotein(a) and Cardiovascular Disease: Key Points

What Is Lipoprotein(a)? 

Most people are familiar with cholesterol basics. HDL is the "good" cholesterol, and LDL is the "bad." However, Lipoprotein(a), or Lp(a), is a form of low-density lipoprotein that includes an extra protein called apolipoprotein(a). This unique structure makes it challenging to manage. Unlike LDL cholesterol, which you can lower with lifestyle changes, Lp(a) levels are largely determined by your genetics. If your parents had high Lp(a), you probably do, too, regardless of your diet or exercise habits. Elevated Lp(a) levels increase the risk of serious cardiovascular conditions like heart attacks, strokes, and aortic valve disease. Lp(a) promotes plaque buildup in the arteries, which leads to atherosclerosis. When a heart doctor discusses unexplained cardiovascular risks, Lp(a) is a factor that needs to be addressed.

How Does High Lp(a) Affect Your Heart Health? 

The presence of high Lp(a) levels can cause a build-up of these particles in the arteries, which contributes to plaque formation while also having inflammatory properties. Inflamed plaque is more likely to rupture and trigger blood clots that can lead to heart attacks or strokes. This creates a dual threat of clogged arteries combined with an elevated risk of blood clots. For individuals already dealing with high LDL cholesterol, hypertension, or diabetes, the additional risk from Lp(a) becomes even more concerning. The most unsettling part is that high Lp(a) levels usually present no symptoms, so it can be a silent risk factor. Speaking with a cardiologist who understands the complexities of Lp(a) is important for appropriate testing and management.

Who Should Be Concerned About Their Lp(a) Levels? 

Lp(a) screening isn’t necessary for everyone, but certain groups should take extra precautions. If you have a strong family history of heart disease, consider getting tested. A history of a close relative, such as a parent or sibling, experiencing a heart attack or stroke at a young age is a warning sign. If you’ve had a heart attack or stroke with no obvious risk factors like high LDL cholesterol or smoking, Lp(a) could be the missing piece of the puzzle. People with unexplained cardiovascular risks should also be cautious. Even if your cholesterol and blood pressure are in a healthy range, your heart doctor might still be concerned about your risk profile. High Lp(a) could be a contributing factor worth investigating. For those without a family history or additional risk factors, routine Lp(a) testing may not be necessary. Discussing your specific situation with a healthcare provider is always a good idea, as being informed can offer an advantage in managing heart health.

Can You Do Anything to Lower Lp(a) Levels? 

LDL cholesterol can be managed through diet, exercise, and medication, but Lp(a) is less responsive to these interventions. Currently, there are no FDA-approved treatments specifically for lowering Lp(a) levels. Genetic factors play a major role, so lifestyle modifications are less impactful. Despite the lack of targeted treatments, there is hope. Researchers are actively developing therapies to lower Lp(a), and early studies show promise. Until these options become available, managing overall cardiovascular risk is the focus. A heart doctor might recommend strategies to lower LDL cholesterol, control blood pressure, and adopt a heart-healthy lifestyle. While these measures don’t directly affect Lp(a) levels, they contribute to better heart health overall. Consistent exercise, a diet low in saturated fats, and effective stress management remain a priority. A trusted cardiologist can offer guidance to fit your specific circumstances.