Heart Health Month Spotlight: Understanding the Role of Lipoprotein(a)

Cardiovascular disease continues to be one of the leading causes of death worldwide, regardless of various well-established interventions.  As we celebrate Heart Health month, it’s important to be aware of the role that lipoproteins play in our overall wellness.  Many of us are aware that cholesterol levels (Total, HDL, LDL, & Triglycerides) should be monitored, however the measurement of lipoprotein is less commonly utilized and could have significant clinical benefits to patients and healthcare systems.

Cholesterol is carried through the bloodstream by lipoproteins, including LDL, HDL and Lipoprotein(a) (Lp(a)). High levels of Lp(a) have been shown to increase the likelihood of having a heart attack or stroke.  Lp(a), like LDL-cholesterol, can build up along the walls of blood vessels depositing plaques in various parts of the body.  Lp(a) also causes increased clotting and promotes inflammation, leading to rapid forming blockages in blood vessels and increased likelihood that deposited plaques will rupture. Unlike LDL cholesterol levels which are significantly impacted by diet and exercise, Lp(a) levels are predominantly genetically predetermined. Routine cholesterol screening does not include Lp(a), despite roughly 20-30% of the global population having elevated levels. Current guidelines recommend that Lp(a) be measured in patients with personal or familial history of premature cardiovascular disease, and those with familial hypercholesterolemia.

References:

Genomics and Precision Health Blog- Archive; Measuring Lipoprotein(a) in Clinical Practice to Reduce the Burden of Cardiovascular Disease? Still Work in Progress., 2022. CDC.gov. Accessed January 31, 2025. https://blogs.cdc.gov/genomics/2022/08/09/measuring-lipoprotein-a/

Heart Disease, Family Health History, and Familial Hypercholesterolemia; About Lipoprotein (a), 2024. CDC.gov. Accessed January 31, 2025. https://www.cdc.gov/heart-disease-family-history/about/about-lipoprotein-a.html