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When we think of key drivers of heart diseases, we think of high blood pressure, high cholesterol, diabetes, and obesity. However, one factor that often goes unnoticed but is actually quite fatal for the heart is lipoprotein (a) or Lp (a). While the primary purpose of Lp (a) is to carry cholesterol, a high level of it is considered a risk factor for cardiovascular diseases. In fact, high lipoprotein (a) levels can double or even triple your risk of a heart attack.
Additionally, Lp (a) levels don’t fluctuate much with diet or lifestyle, as they are mostly determined by genes you inherit, making it crucial to test for them early if you are at risk.
To help you better understand and manage this condition, here is all you need to know about lipoprotein (a):
What is Lipoprotein A?
Lipoprotein (a) is a type of protein that carries cholesterol, a fatty substance, in the blood. While Lp(a) is a bit similar to LDL, or low-density lipoprotein (also called bad cholesterol), it contains a unique protein called apolipoprotein(a) (apo(a)). Apolipoprotein(a) can prevent the enzymes from dissolving blood clots, thus increasing the risk of clots forming in the arteries. A high LP (a) level can also form plaque on blood vessel walls, which leads to narrowing or blocking of blood vessels and the hardening of arteries.
Causes of Elevated Lipoprotein A
Now that you know the meaning of high lipoprotein (a), let's understand its cause. The primary cause of high lipoprotein A is genetics. This means that LP(a) levels are not influenced by environmental or lifestyle factors.
Besides genetics, Lp(a) levels can also vary among different ethnic groups. Research indicates that people of African descent and South Asian descent tend to have higher Lp(a) levels compared to white individuals, Asians and Hispanics.
Additionally, certain conditions, such as kidney disease or autoimmune disorders, may also cause high lipoprotein A levels.
Symptoms of High Lipoprotein(a)
There are no direct symptoms of high lipoprotein(a), which is why it is often called a “silent killer.” Its presence typically does not manifest until it contributes to serious health conditions.
However, someone with elevated Lp(a) might experience symptoms related to complications caused by it, such as:
- Shortness of breath: If plaque builds up in the arteries, it can narrow them and reduce blood flow to the heart and lungs, causing shortness of breath even during mild physical activity.
- Chest pain: This could be a sign of coronary artery disease (CAD), especially if it occurs during activity or stress.
- Fatigue: Someone can feel tired or weak from the heart working harder to pump blood.
- Stroke-like symptoms: Symptoms like sudden weakness on one side, difficulty speaking, or visual changes may indicate stroke caused by Lp(a)-related clotting.
- Leg pain or cramping: Pain in the leg during walking or resting can be caused by peripheral artery disease (PAD), which Lp(a) can contribute to.
Diagnosis of Lipoprotein A Levels
High lipoprotein (a) levels can be diagnosed through the Lp(a) test. However, this test is not a part of standard cholesterol panels and must be done separately.
Doctors may recommend an LP (a) test to someone if their family medical history is unknown or they have:
- A strong family history of early heart diseases (before age 55 for a father or brother and before age 65 for a mother or sister)
- Had a heart attack or stroke with normal LDL levels
- An inherited higher risk of high cholesterol levels
- A history of premature coronary artery disease
The Lp(a) test is performed by taking a small blood sample from a vein in your arm. Generally, no special preparation, such as fasting, is required for this test. However, if any specific instructions or preparations are required, your healthcare provider will inform you beforehand.
Normal Levels of Lipoprotein (a)
The lipoprotein (a) normal value is less than 30 milligrams per deciliter (mg/dL) of blood. Anything above that is considered abnormal and is indicative of an increased risk for cardiovascular diseases.
Here is the range of abnormal results:
- Borderline risk (14 to 30 mg/dL).
- High risk (greater than 31 to less than 50 mg/dL).
- Highest risk (higher than 50 mg/dL).
Please note that the Lp(a) normal level range can vary between different labs. For more accurate interpretation of your Lp(a) test results, always consult with your doctor.
Treatment for Elevated Lipoprotein (a) Levels
When it comes to the treatment of high lipoprotein (a), doctors generally prescribe medication, such as:
- Statins
- PCSK9 inhibitors
- Aspirin
Beyond medications, there is a procedure called apheresis that removes Lp(a) from the blood, but this is reserved for very rare cases. It is similar to how dialysis works, taking out the waste from your blood when your kidneys don’t work. However, this treatment is only for people with familial hypercholesterolemia (a genetic disorder that causes high levels of LDL ("bad") cholesterol).
Researchers are also trying to come up with more treatments for Lp(a), as medications are not helping lower it as much.
Managing Elevated Lipoprotein (a) Levels
Even though you can not lower a high Lp(a) with diet or exercise, there is still a lot you can do to reduce your overall risk of heart disease, including:
- Following a healthy diet: Include omega-3 oils, nuts, olive oil and some other vegetable oils, whole grains, fruits, and vegetables in your diet. Avoid saturated and trans fats, such as those found in fatty meat, dairy, and processed foods.
- Exercising regularly and managing weight: Being physically active and managing your weight can lower bad cholesterol and increase good cholesterol.
- Reducing stress: Chronic stress can lead to increased bad cholesterol levels. So, meditate regularly, exercise and do whatever you can to reduce your stress.
- Quit smoking: Smoking can also negatively impact your heart health.
- Limiting alcohol: Lowering your alcohol consumption can improve your heart health. To limit or stop alcohol consumption, you can also seek help and support from medical and mental healthcare professionals and support groups.
- Getting better sleep: Sleeping at least 7-8 hours daily can help the heart and blood vessels recover and repair.
In conclusion, high lipoprotein (a) levels can increase the risk of cardiovascular disease in individuals. The primary cause of elevated Lp(a) levels is genetic, which means they remain the same throughout a person’s life. While the symptoms of high Lp(a) are not obvious, its long-term impact on heart health can be profound. So, if you have a family history of early heart disease, personal heart-related problems without a clear cause, or elevated cholesterol levels, talk to your doctor about getting tested for Lp(a).
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