LDL, HDL, triglycerides—these are familiar terms to just about anyone who’s had their cholesterol levels checked.
But there’s another cholesterol marker you won’t find on a standard lipid panel. One that signals dramatically increased risk for developing cardiovascular disease (CVD). And unfortunately…most people have no idea it exists.
We’re talking about lipoprotein(a)—often abbreviated as Lp(a).
What Is Lipoprotein(a)?
Lp(a) is a specific lipoprotein particle, similar in structure to LDL. However, it has an extra protein attached to it called apolipoprotein(a). It’s apolipoprotein(a) that gives Lp(a) its unique and problematic characteristics (distinct from standard LDL).
One of Lp(a)’s troubling features is its tendency toward promoting plaque formation inside artery walls. To complicate matters further, Lp(a) also interferes with the body’s ability to naturally dissolve blood clots.
Who’s Affected?
Of inherited CVD risk factors, elevated Lp(a) is one of the most common. Roughly one in five people worldwide are at an increased risk for atherosclerosis, heart attack, stroke, and aortic valve disease as a consequence of elevated Lp(a).
Which begs the question:
What can a person do if they have elevated Lp(a) levels?
That’s part of the problem. Unlike LDL cholesterol—which responds well to diet, exercise, and medication—Lp(a) levels are driven almost entirely by genetics. Eating well and staying active are excellent habits, but they will not lower Lp(a) if you have inherited a tendency toward elevated levels.
This is what makes Lp(a) so clinically important:
It’s an indicator of risk that healthy lifestyle choices alone cannot address.
The Testing Gap
Unfortunately, Lp(a) is almost never included on a standard lipid panel. And because other cholesterol numbers may be within range even when Lp(a) is high, physicians often don’t look any deeper.
As a consequence, most people who have elevated Lp(a) don’t know it. Meanwhile, elevated Lp(a) is quietly increasing risk.
The good news is that testing Lp(a) is straightforward. It’s a simple blood test, and most people only need to have it done once in their lifetime, since levels remain relatively stable over time. It’s worth noting that major cardiovascular organizations, including the European Society of Cardiology and the American Heart Association, have started calling for broader Lp(a) screening, particularly for anyone who has a personal or family history of early cardiovascular disease.
Lp(a) and Hormones
There’s an additional layer of nuance here related to hormones. And that nuance is worth understanding.
Estrogen has a modest influence on Lp(a) levels, with healthy estrogen levels being associated with a reduction in Lp(a) in some studies. This is of consequence for both women and men, and means that properly managed hormone optimization can have real implications when it comes to long-term cardiovascular health.
What Can Be Done About Elevated Lp(a)?
Because Lp(a) is genetically driven, treatment is focused less on lowering Lp(a) and more on aggressively managing all other CVD risk factors. That means managing other cholesterol markers, maintaining healthy blood pressure, optimizing metabolic health, and addressing inflammation.
This is what can be done for the moment. Emerging therapies that target Lp(a) are in clinical development, with early results that are promising. It’s likely there will be new treatment options available in the coming years.
In the meantime, the most important first step is to simply know your number, so you can take steps to maximally manage other CVD risk factors.
Know Your Risk
You can’t manage what you don’t measure. If you’ve never had your Lp(a) tested—or if you have a family history of heart disease that seems to defy explanation—it’s worth asking about this test.
At Renew Youth, we take a comprehensive approach to cardiovascular health, including advanced testing that standard testing panels often miss. To learn more, call us at (800) 859-7511 or use our easy contact form to schedule your complimentary 30-minute consultation.