Understanding Lipoprotein(a): A Commonly Overlooked Heart Risk Factor

What Is Lipoprotein(a)?

Lipoprotein(a), often abbreviated as Lp(a), or “LP little a” is a type of cholesterol particle found in your blood. Structurally, it is similar to LDL, but with an added protein called apolipoprotein(a). This unique structure makes Lp(a) particularly sticky and more likely to contribute to the buildup of plaque in arteries, a process known as atherosclerosis.

How Does Lp(a) Relate to Heart Disease Risk?

Elevated Lp(a) levels are a well-established, independent risk factor for cardiovascular disease (CVD), including heart attacks, strokes, and aortic valve disease. Unlike LDL cholesterol, Lp(a) levels are largely determined by genetics and are not significantly influenced by diet or lifestyle. High Lp(a) can accelerate plaque formation which raises the risk for cardiac events.

Why Is It Important to Check Lp(a)?

• Silent Risk: Many people with high Lp(a) have no symptoms until a major event, such as a heart attack or sudden cardiac death, occurs.

• Family History: If you have a family history of early heart disease or unexplained strokes, checking Lp(a) can reveal hidden risk.

• Personalized Care: Knowing your Lp(a) level allows for more tailored prevention strategies, especially if your traditional cholesterol numbers are normal but your risk remains high.

  
  

Why Don’t More Doctors Check Lp(a)?

Despite its importance, Lp(a) is not routinely measured in standard cholesterol panels. Reasons include:

• Lack of Awareness: Many healthcare providers are not fully aware of the significance of Lp(a) or current guidelines.

• Limited Treatment Options: Until recently, there were few effective ways to lower Lp(a), which reduced the perceived value of testing.

What Can Be Done to Manage High Lp(a)?

While Lp(a) is primarily genetic, there are steps you can take:

• Lifestyle Foundations: Healthy diet, regular exercise, and optimal sleep remain essential for overall cardiovascular health.

• Pharmacological Strategies: While there is no FDA-approved medication specifically for lowering Lp(a) yet, certain therapies—such as PCSK9 inhibitors and niacin—can modestly reduce levels in some patients. New drugs targeting Lp(a) are in development and may soon offer more options.

• Aggressive Risk Factor Management: If you have high Lp(a), it’s crucial to control other risk factors like high LDL cholesterol, high blood pressure, and diabetes.

• Individualized Care: At Mission Metabolic Health, we go beyond the standard of care, developing personalized pharmacological strategies that maximize protection while minimizing side effects.

  
  

The Importance of Cardiovascular Screening

Cardiovascular disease often develops silently, and for some, sudden cardiac death is the first sign. Early screening—including advanced tests like Lp(a)—can identify risk before symptoms appear, allowing for proactive intervention and prevention.

Our Approach at Mission Metabolic Health

At Mission Metabolic Health, we are committed to comprehensive cardiovascular screening, including Lp(a) testing when appropriate. Our approach includes:

• Thorough risk assessment beyond standard cholesterol checks

• Use of foundational lifestyle tools: nutrition, exercise, and sleep optimization

• Personalized pharmacological plans to address elevated risk without unnecessary side effects

Your heart health is too important to leave to chance. By identifying and managing all aspects of cardiovascular risk—including Lp(a)—we help protect you from the unexpected.