Elevated lipoprotein(a), often abbreviated as Lp(a), is a condition where levels of a specific type of cholesterol in your blood are higher than normal. This guide explains the condition, its causes, symptoms, treatments, and how to manage living with it.
What is Elevated Lipoprotein(a)?
Lipoprotein(a), or Lp(a), is a type of cholesterol particle in your blood. It is similar to low-density lipoprotein (LDL, or “bad cholesterol”) but has an additional protein called apolipoprotein(a). High levels of Lp(a) in your blood increase your risk of developing cardiovascular diseases such as heart attacks, strokes, and aortic valve disease.
Unlike other forms of high cholesterol, elevated Lp(a) is primarily determined by your genes and is not significantly influenced by lifestyle factors like diet or exercise.
Key Facts About Elevated Lipoprotein(a)
Background
- Elevated Lp(a) is often referred to as a “silent risk factor” because it does not cause symptoms on its own but contributes to the development of cardiovascular diseases over time.
- It was first identified in the 1960s and has since been recognised as an independent risk factor for heart disease.
Causes
- Elevated Lp(a) levels are caused by genetic variations in the LPA gene, which determines how much Lp(a) your body produces.
- Unlike other cholesterol types, lifestyle factors like diet, weight, or exercise have little effect on Lp(a) levels.
Incidence and Prevalence
- Incidence: Refers to how many new cases occur each year. Since elevated Lp(a) is genetic, it is present from birth rather than being acquired later in life.
- Prevalence: Approximately 20–30% of people worldwide have elevated Lp(a) levels (above 50 mg/dL or 125 nmol/L).
Who is Affected?
- Age: Elevated Lp(a) levels are present from birth and remain relatively stable throughout life.
- Gender: Both males and females are equally affected, although women may experience a slight increase in levels after menopause.
- Ethnicity: People of African descent are more likely to have elevated Lp(a) levels compared to those of European or Asian descent.
Geographic Distribution
- Elevated Lp(a) occurs worldwide but may be more prevalent in certain populations due to genetic differences.
How Does Elevated Lipoprotein(a) Impact You?
Symptoms
Elevated Lp(a) itself does not cause noticeable symptoms. However, it increases your risk for:
- Atherosclerosis (hardening and narrowing of the arteries).
- Heart attacks (blockage of blood flow to the heart).
- Strokes(blockage or rupture of blood vessels in the brain).
- Aortic valve stenosis (narrowing of the valve that controls blood flow from the heart to the rest of the body).
If you have a family history of early heart disease or stroke, you may be at higher risk due to elevated Lp(a).
Living With Elevated Lipoprotein(a)
Living with elevated Lp(a) involves managing your overall cardiovascular risk through lifestyle changes and medical treatments. Regular monitoring by a healthcare professional is essential.
Expected Life Expectancy
With proper management and treatment, individuals with elevated Lp(a) can live a normal lifespan. However, untreated high levels can significantly increase the risk of premature cardiovascular events.
Managing and Treating Elevated Lipoprotein(a)
Available Treatments
Currently, there are no medications specifically approved to lower Lp(a), but several strategies can help manage its associated risks:
- Medications for Cardiovascular Risk Reduction:
- Statins: Lower LDL cholesterol levels but do not directly affect Lp(a). They are often prescribed to reduce overall cardiovascular risk.
- Aspirin: May be recommended for individuals at high risk of blood clots.
- PCSK9 Inhibitors: These injectable medications lower LDL cholesterol and may also modestly reduce Lp(a).
- Lifestyle Changes:While lifestyle factors do not directly lower Lp(a), they help reduce other cardiovascular risks:
- Eat a heart-healthy diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats.
- Exercise regularly (at least 150 minutes of moderate activity per week).
- Avoid smoking and limit alcohol intake.
- Maintain a healthy weight.
- Emerging Treatments:New therapies targeting Lp(a) specifically are under development:
- RNA-based therapies like pelacarsen aim to reduce the production of Lp(a) in the liver.
- Regular Monitoring: If you have elevated Lp(a), regular check-ups with your doctor can help track your cardiovascular health.
Ongoing Clinical Research
Research into elevated Lp(a) continues to focus on understanding its role in cardiovascular disease and developing targeted treatments:
- RNA Interference Therapies: Drugs like pelacarsen are being tested in clinical trials for their ability to lower Lp(a) levels significantly.
- Genetic Studies: Researchers are studying variations in the LPA gene to better understand why some people have higher levels than others.
- Biomarker Research: Efforts are underway to improve diagnostic tools for assessing cardiovascular risks associated with elevated Lp(a).
For more information on ongoing research studies, visit clinicaltrials.gov.
Support Groups and Resources
If you have been diagnosed with elevated lipoprotein(a), connecting with support groups can provide valuable information and emotional support:
- Heart UK – The Cholesterol Charity (org.uk)– Offers resources specifically for individuals with lipid disorders like elevated Lp(a).
- British Heart Foundation (BHF) (org.uk)– Provides general support for people living with cardiovascular risk factors.
- The Lipoprotein(a) Foundation (org) – Focuses on raising awareness about elevated lipoprotein(a).
Remember:
This information is intended for general knowledge and educational purposes only and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.