The “Little” Heart Health Risk that Poses Big Problems

Lp(a), known as “LP little a,” is similar to LDL cholesterol – elevated levels pose a serious cardiovascular risk. High Lp(a) is a genetic disorder, with people having a 50% chance of passing it on to their children.  Lp(a) is considered high if it is above 50 mg/dL.

Lifetime exposure to high LP(a) causes gradual narrowing of arteries.  That limits blood supply to the heart, brain, kidneys and legs. It also leads to heart disease, stroke and atherosclerosis.

In fact, some experts acknowledge LP(a) as the strongest single genetic risk factor for heart disease.

Nevertheless, awareness and screening for LP(a) are seriously lacking.

Lp(a) Screening

Though roughly 1.4 billion people around the world live with elevated Lp(a), the condition is rarely screened for during routing cholesterol tests.  It should be. Lp(a) screening should be considered particularly for people with:

• Early heart disease or a family history of early heart disease
• A family history of high Lp(a)
• Familial hypercholesterolemia, a genetic cause of high LDL cholesterol
• Persistent heart disease even with optimal management

Although there are no treatments available to lower high Lp(a), several therapies are being studied in clinical trials. Cardiovascular disease prevention guidelines around the world recognize high Lp(a) as a risk factor for heart disease. Further recommendations for clinical practice await clinical trial results.

In the meantime, to maximize health and minimize risk:

• Patients with elevated Lp(a) should continue maintaining a heart-healthy lifestyle
• Providers should screen for elevated Lp(a), especially in patients with a history of cardiovascular disease
• Policymakers should ensure screening for Lp(a) is both accessible and affordable.

When it comes to heart health, there’s nothing “little” about the risk that Lp(a) poses – or the importance of proactively addressing it.