Lipoproteins are soluble proteins that mix with and transport fats (lipids) in the blood. Lipoprotein a, often known as Lp(a), is produced in the liver and is inherited genetically. Lp(a) is similar in structure to LDL cholesterol but has an additional protein known as apolipoprotein(a) attached to it.

Lp(a) has been the subject of much research in recent years due to its association with an increased risk of cardiovascular disease (CVD). Many experts feel it is an important and underused blood marker of CVD. Studies have shown that high levels of Lp(a) can increase the risk of cardiovascular disease. This is because Lp(a) can deposit in the arteries, leading to the development of plaque. Plaque build-up can narrow the arteries, which can lead to a heart attack or stroke.

How is Lp(a) Measured?

Whilst Lp(a) is often not checked, Measuring Lp(a) in the blood is a simple process that can be done with a routine blood test at Sloane Street Surgery.

The results of an Lp(a) test are typically reported in milligrams per deciliter (mg/dL) or millimoles per litre (mmol/L). The optimal range for Lp(a) is not yet well-established, but experts suggest that levels greater than 50 mg/dL or 125 nmol/L may be associated with an increased risk of CVD.

What Does an Elevated Lp(a) Level Mean?

Elevated levels of Lp(a) in the blood are associated with an increased risk of cardiovascular disease. Specifically, high levels of Lp(a) have been shown to increase the risk of developing atherosclerosis, which is a build-up of plaque in the arteries that can lead to heart attack and stroke. The exact mechanisms by which Lp(a) contributes to atherosclerosis are not yet fully understood, but it is thought that the apo(a) protein may interfere with the breakdown of LDL and other lipids in the blood, leading to the accumulation of plaque in the arteries.

In addition to its role in cardiovascular disease, Lp(a) has also been associated with other health conditions. For example, high levels of Lp(a) have been linked to an increased risk of aortic stenosis, a condition where the aortic valve in the heart becomes narrowed. Lp(a) has also been associated with an increased risk of diabetes, although the exact relationship between the two is not yet fully understood.
The levels of Lp(a) can also be affected by factors such as age, gender, and lifestyle choices such as smoking and diet.

There are also genetic factors that can influence Lp(a) levels. Some people have inherited variations in the LPA gene that cause them to produce more apo(a) protein, which in turn leads to higher levels of Lp(a) in the blood. These genetic variations are relatively common, affecting up to 20% of the population, and can lead to a substantially increased risk of CVD.

What Can You Do About an Elevated Lp(a) Level?

While lifestyle changes such as a healthy diet, regular exercise, and not smoking can help reduce your Lp(a) levels to some extent, there is no specific medication or treatment that can effectively lower Lp(a) levels.

If you have a raised Lp(a) level, it’s important to work closely with your healthcare provider to manage any underlying cardiovascular risk factors you may have, such as high blood pressure or diabetes. In addition, your healthcare provider may recommend other interventions to help reduce your cardiovascular risk, such as prescribing cholesterol-lowering medications like statins, which can lower your LDL (“bad”) cholesterol levels and may also have some effect on Lp(a).

Overall, the best way to manage a raised Lp(a) level is to work with your GP to develop a comprehensive plan that addresses all of your cardiovascular risk factors.

Read Asif’s story.

I am young and I do not smoke but I have such a strong family history of diabetes stroke and heart attack and I wanted to be on top of my heart disease risk in every way I could. I spoke to my doctor about starting a statin as I have high cholesterol, and we were not quite decided. After reading about the lipoprotein A test, I realised it could provide additional information that would be useful to me in making a decision as to whether to treat my cholesterol or not with pills. My Lipoprotein A was very high and so we agreed to start medications. Whilst the result was not what I wanted, I am pleased to have more information on which to base this vital decision


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