When doctors evaluate heart health, they are concerned about the cholesterol content of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) particles — particles that carry cholesterol through the blood. However, there is an additional fatty, sticky, lipoprotein particle you need to be aware of: lipoprotein(a), also known as Lp(a), which poses a high risk of early cardiovascular disease.

The risks of Lp(a)

 Lp(a) is the most prevalent genetic risk factor for coronary heart disease and aortic valve disease.

High levels of Lp(a) travel through the bloodstream and enter into the arteries, leading to gradual narrowing of the artery. This narrowing can limit the blood supply to the heart or brain, thereby increasing the risk of blood clots, heart attack, stroke and aortic valve disease. Currently, Lp(a) is the most prevalent genetic risk factor for coronary heart disease and aortic valve disease. Globally, one in five people have inherited high Lp(a) — 63 million in the United States alone.

Avoiding dangerous first signs

People with high levels of Lp(a) can be at risk even if they are physically fit and have normal LDL or HDL cholesterol levels. Unfortunately, for many people, the first sign of the disease is a heart attack or stroke.

A simple blood test can measure Lp(a) concentrations, but it is not included in most standard lipid panel tests that check cholesterol levels. However, knowing your Lp(a) level could be the first step in preventing up to 120,000 cardiovascular events in the United States every year.

The ESC/EAS and Canadian Lipid guidelines acknowledge the significance of Lp(a) as an independent, genetic risk factor for cardiovascular disease. “Fit, healthy people can inherit genetic factors like high Lp(a) that cause early heart disease,” said Sandra Revill Tremulis, president and founder of Lipoprotein(a) Foundation.

“We are advocating that Lp(a) testing be added to the standard cholesterol test to increase the rate of early diagnosis and provide a more accurate prediction of risk.”