Your doctor ignores it because there are no medications to prescribe for it.
Also, it is up to 90% genetically determined.
But, if you find out you’re genetically prone to high levels, that makes managing the heart disease risk factors you can control all the more important.
Around 1 in 5 people do have unhealthy, elevated levels of LP(a) – and that can cause severe heart disease even in otherwise healthy-seeming people – including young people.
LP(a) is short for lipoprotein little a.
LP(a) is basically an LDL (low-density lipoprotein) cholesterol with an apoprotein attached to it.
LDL of course is the “bad” cholesterol – and LP(a) is bad cholesterol, made even worse than ordinary LDL.
It causes or contributes to:
* Coronary heart disease
* Myocardial infarction
* Heart failure
* Peripheral artery disease
* Calcified aortic valve disease
Basically, LP(a) gets into the lining of your blood vessels. This contributes to inflammation and atherosclerotic plaque.
Although doctors commonly measure LDL, HDL, and total cholesterol in your blood, most do not pay any attention to your LP(a) levels.
This is unfortunate because knowing you’re at a higher risk of heart disease because of your high LP(a) would hopefully make you more likely to quit smoking, exercise moderately, and eat a healthy diet.
It’s a good idea for everybody to keep their ordinary LDL level below 70 and total cholesterol below 150, but it’s critical for people who have genetically high LP(a).
One famous example is Bob Harper, one of the trainers on The Biggest Loser TV show. Although physically fit and although he passed his annual checkups, at the young age of 52 he suffered a heart attack.
He had what The New York Times called “perilously high” levels of LP(a). However, that was never measured before his heart attack.
The amount of LP(a) in the blood can vary dramatically. Someone might have 0.1 mg/dL and someone else might have 387 mg/dL.
Less than 20 is considered optimal. Between 30 and 50 is considered elevated.
One Treatment Costs $50,000 Per Year
Researchers have verified LP(a)’s ability to cause dangerous plaque by having patients with high levels go through the process of apheresis.
That’s when they remove blood from you, clean out the LP(a), and then send it back in.
This works, but it’s only a temporary fix because LP(a) levels creep back up, requiring a treatment every other week or more.
LP(a) Does Increase Your Blood’s Ability to Clot
This was no doubt beneficial for people in the past. Long before ambulances took injured people to Emergency Rooms for treatment, having fast-clotting blood was a good thing after you’ve been stabbed by an enemy or ripped by a lion. Many women need blood clotting medication when giving birth.
Today, however, most of us do not need to worry about bleeding to death.
More Americans die of heart disease than anything else.
And having elevated LP(a) increases your risk by 2-3 times.
Although statin drugs are the go-to medication for people with high cholesterol, but they do NOT affect LP(a) even though it is a variant of cholesterol.
Some doctors put people with high LP(a) on the B vitamin niacin. But this is controversial. There’s no consensus that this helps keep you alive longer.
There are indications eating lots more plants, especially fruits and vegetables, can lower LP(a).
Certain specific foods seem to drop LP(a), although the evidence is not definitive. They include:
* Amla, also known as the Indian gooseberry. You can buy dried amla powder online or at your local Indian/Pakistani food store.
* Almonds, and probably other seeds and nuts
Have your doctor test your LP(s) levels along with the standard lipid panel.
This is especially important if you have a family history of heart attack at a young age, before 60.
In my own opinion, the smartest thing to do is to assume the worst, and do everything you can to protect yourself from heart disease:
* Exercise moderately
* Manage your stress
* Eat an anti-inflammatory diet
* Keep LDL below 70 and total cholesterol below 150
* Don’t smoke
* Don’t drink alcohol, or at least keep it minimal
All of the above will lower your risk of heart disease as much as possible.