Taking care of your cardiovascular health: lipoprotein(a)
What are lipoproteins?
Lipoproteins are particles that transport different lipids (cholesterol, triglycerides, etc.) in the blood. As their name suggests, they are composed of proteins and lipids. There are different types, which are distinguished by the type of protein they contain and the lipid content they transport. The best known are low-density lipoprotein (LDL), high-density lipoprotein (HDL), chylomicrons, and lipoprotein(a).
What should we know about lipoprotein(a)?
Lipoprotein(a), also known as Lp(a), is one of the lipid particles that circulates in our blood. Its role in the body, that is, its biological function, is not fully understood. Some suggest that at some point in evolution it was involved in healing and immunity from skin injuries.
Lipoprotein(a) is unique in that its levels are genetically determined. This characteristic explains why diet and the various treatments we use to control lipids on a regular basis have little impact on its levels. There are specific situations, such as poorly controlled hypothyroidism, menopause, and chronic kidney disease, among others, that can cause variability in blood levels of lipoprotein(a).
High values are defined as levels above 70 mg/dL or 120 nmol/L, depending on the unit of measurement used by each laboratory. It is estimated that between 20-25% of the population has values above these figures.
Why is it important to know your lipoprotein(a) levels?
Today we know that high lipoprotein(a) levels are associated with an increased risk of cardiovascular events such as acute myocardial infarction, stroke, or blockages in other arteries in the body. We also know that high levels increase the risk of aortic valve stenosis. Having high lipoprotein(a) levels does not necessarily mean that you will have a cardiovascular event. As in many other situations, there are people who have high levels and do not have cardiovascular events. That is why it is important to contextualize these values with other characteristics of the individual (e.g., family history of cardiovascular disease at a young age, high blood pressure, diabetes, smoking, etc.) in order to better stratify each individual's cardiovascular risk.
Who should have their lipoprotein(a) levels measured?
The Argentine Lipid Society recommends that everyone have a lab test to find out their lipoprotein(a) levels at least once in their lifetime. The groups of people who will benefit most from knowing their levels are:
- People with premature cardiovascular disease (heart attack or stroke before age 55),
- People with Familial Hypercholesterolemia
- People with a family history of premature cardiovascular disease
- People with a family history of elevated Lp(a)
- People with recurrent cardiovascular disease despite adequate treatment.
- People with aortic valve stenosis, especially if it occurs at an early age.
Is there a specific treatment?
To date, we do not have specific treatments to reduce these values, and we still do not know whether the drugs being studied for this purpose reduce the risk of cardiovascular events.
People with high lipoprotein(a) levels should intensify their efforts to lead a healthy lifestyle, maintain a healthy weight, refrain from smoking, and properly control other risk factors (blood pressure, blood sugar). In some cases, and always under medical supervision, other cholesterol-lowering medications such as statins may be used, and in some cases a low dose of aspirin may also be prescribed.
At the Medical Center , we have a Cardiometabolism Center, highly specialized in lipid disorders, with the latest technologies and a top-level interdisciplinary medical team, to offer you the best care and treatment tailored to your needs.
Remember that taking care of your cardiovascular health is a fundamental step toward a longer and healthier life.
Dr. Augusto Lavalle Cobo | Head of the Cardiology Center
