Chances are you do not know if your Lipoprotein(a) level is elevated because it has never been measured. Lipoprotein(a), also known as Lp(a), is a particle in the blood that carries cholesterol and resembles LDL except that it includes an extra protein [apolipoprtotein(a)] that adds risk. Elevated Lipoprotein(a) is an important risk factor for heart attacks, stroke and aortic stenosis.
1 of 5 people worldwide have an elevated Lipoprotein(a) level, fewer than 1% of people in the United States have had it measured.
Although it is estimated that 1 of 5 people worldwide have an elevated Lipoprotein(a) level, fewer than 1% of people in the United States have had it measured. However, as awareness about Lipoprotein(a) increases, this may change. Guidelines in Europe issued by the European Atherosclerosis Society recommend that everyone with intermediate, moderate, or high risk of developing heart disease have a Lipoprotein(a) measure at least once in their life. There are now similar recommendations in other countries.
Since few doctors routinely measure Lipoprotein(a), you may have to bring it up at your next health care appointment if you'd like to be tested. Ask your health care provider whether a Lipoprotein(a) assessment is appropriate for you, and for a Lipoprotein(a) measurement to be included with your next blood test. If you do, it may be helpful to bring along some medical information about Lipoprotein(a) to share with your doctor.
Since Lipoprotein(a) level is mostly determined by your genes, levels change very little throughout your life and are unaffected by diet and exercise.
It is also important to understand a few features of Lipoprotein(a) measurement. It can be measured in 2 different ways that are distinguished by the units. Sometimes Lipoprotein(a) is measured by mass (mg/dL); a level >50 mg/dL is elevated. More commonly, it is measured by particle number (nmol/L); a level >125 nmol/L is elevated. Since Lipoprotein(a) level is mostly determined by your genes, levels change very little throughout your life and are unaffected by diet and exercise. Thus, it is most important to measure it once in your lifetime to determine if your level is elevated. If it is elevated, there is a 50% chance your first-degree relatives will also be elevated, so it becomes important for them to also be checked. Understanding your risk of heart disease by measuring Lipoprotein(a) to determine whether it is elevated is a step in understanding your health risks. And while there are currently not any specific medications to lower Lipoprotein(a), studies are underway and could result in medications in as little as 4 or 5 years. Importantly, other studies have found that in persons with elevated Lipoprotein(a), treating all other cardiac risk factors (cigarette smoking, diabetes, high blood pressure, elevated LDL cholesterol) and eating a healthy diet, exercising regularly, and maintaining a healthy body weight can reduce risk by as much as 66%.
If you have elevated Lipoprotein(a) or would like to learn more about it the Family Heart Foundation is here for you. Visit our Care Navigation Center for any questions.
