Lipoprotein(a) [Lp(a)] – pronounced “lipo-protein little a”, or “LP little a” is the most common inherited risk factor for heart disease. High Lp(a) levels occur in 20% of people, yet only 1-2% have ever been tested. It is structurally very similar to low-density lipoprotein (LDL) cholesterol, which makes Lp(a) uniquely ‘sticky’. This ‘stickiness’ encourages the buildup of fatty plaques and narrowing of arteries increasing the risk of heart attacks and strokes. As high Lp(a) is inherited (i.e., either one or both parents have passed on the gene), the damage can begin in early childhood and accumulates over time. This means that a person who has high Lp(a) is more likely to develop premature heart disease or have a heart-related ‘event’ earlier in life than people who don’t have high levels.

So, what can you do?

If you have a family history of elevated Lp(a), early heart disease or stroke, then speak to your doctor about getting tested. Testing is currently not included in routine blood tests, although it can be easily measured at the same time as a cholesterol (lipids) test. Unfortunately, there is an out-of-pocket cost in Australia, despite international guidelines suggesting everyone should be tested at least once in their lifetime. Whilst medications to lower Lp(a) levels are currently being tested, they are not widely available. The good news is that if you or someone in your family has high Lp(a) levels, you can start lowering your overall traditional heart disease risk factors, straight away! In fact, it is especially important to start early. This includes following a Mediterranean-style diet (fruits, vegetables, legumes/beans, healthy fats, wholegrains, fish, lean proteins), being physically active, maintaining healthy weight, not smoking and making sure your LDL cholesterol levels are well managed.

Author:

Dr. Caroline Hill

Postdoctoral Research Fellow – Edith Cowan University

Nutrition and Health Innovation Research Institute

School of Medical and Health Sciences