Cholesterol Check: The Crucial Information You Might Be Missing
Most of us have heard about LDL "bad" and HDL "good" cholesterol. Your doctor tests for these two main groups when evaluating your cholesterol levels. However, have you heard of lipoprotein(a)? This is not regularly tested in your overall cholesterol levels, but it may be worth asking your doctor about.
What is Lipoprotein (a), and Why Should You Care?
LP(a) is a type of cholesterol that resembles LDL but has an additional protein called Apo(a), which makes it “stickier” than LDL. Because of this, LP(a) can adhere to artery walls more easily, increasing the risk of heart attack, stroke, atherosclerosis, and other cardiovascular issues. Knowing if you have high levels of LP(a) could help you make proactive, heart-healthy choices, especially if you're at higher risk due to family history or other factors.
Should You Ask Your Doctor About an LP(a) Test?
Testing LP(a) is not routine, but you might consider it if you have any of the following:
Family History of Early Heart Disease: If a close family member experienced heart issues before age 55 (for men) or 65 (for women), it may be worth discussing with your doctor.
High LDL Levels Not Responding to Medication: If traditional cholesterol-lowering strategies haven’t worked, knowing your LP(a) level might help explain why.
Existing Heart or Vascular Disease: If you have cardiovascular issues without high LDL or triglycerides, LP(a) could be a contributing factor.
Genetic Hypercholesterolemia: A family history of high cholesterol is another indicator that LP(a) levels could be worth exploring.
Multiple Heart Events: If you’ve had multiple heart attacks or procedures like angioplasty, it’s wise to explore all possible causes.
Are There Treatments Specifically for LP(a)?
Currently, the only FDA-approved treatment for reducing LP(a) in the U.S. is lipoprotein apheresis, a specialized procedure that filters LP(a) from the blood. This treatment is generally recommended for people with:
Heterozygous familial hypercholesterolemia (FH)
LDL cholesterol higher than 100 mg/dL and LP(a) above 60 mg/dL
Coronary artery or peripheral artery disease
Will statins help?
Statins do not lower the amount of LP(a). However, they will shrink the size of the LP(a) lipoproteins. They will also lower non-HDL cholesterol levels.
What about certain supplements?
Niacin is a supplement worth considering. According to the Journal of American Cardiology, it can be used with statin therapy. Results show that Nicacin can decrease LP(a)Niacin by 20%. There have ever been reported cases in the literature of a 60% to 80% reduction in LP(a) levels.
Heart-Healthy Steps for Managing LP(a)
Managing LP(a) is as much about lifestyle as it is about specific treatments. If you have elevated LP(a), consider these heart-healthy habits:
1. Reduce overall heart disease risk by working with your healthcare provider on a targeted plan.
2. Aim for non-HDL cholesterol below 2.5 mmol/L if you're considered high-risk.
3. Eat a heart-healthy diet, focusing on whole foods rich in fiber, antioxidants, and omega-3 fatty acids.
4. Maintain a healthy weight and take steps to manage blood pressure.
5. Quit smoking to protect your blood vessels.
6. Reduce stress through practices like meditation and mindfulness.
7. Exercise regularly to strengthen your heart and improve circulation.
A Hopeful Path Forward
Taking control of your heart health means understanding all the factors that affect it. Knowing your LP(a) levels, especially if you have a higher genetic risk, can give you new insights and more power to prevent serious health issues. With the right support, treatments, and lifestyle changes, you can manage LP(a) and prioritize a long, healthy life.
*As always, this is for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you have regarding a medical condition. AND before undertaking any diet, dietary supplement, exercise, or other health program.