Lipoprotein (a) & Heart Disease: What You Should Know
Lipoprotein (a) is an inherited risk factor for heart disease. High levels may increase cholesterol buildup, affecting heart health—learn ways to reduce risk.
July 1, 2024
What is Lipoprotein (a)?
Like LDL, Lipoprotein(a) (Lp[a]) is type of apoB cholesterol-carrying particle that is disease-causing.It differs in that it has an additional protein attached and has a higher propensity to cause blood vessel disease. Lp(a) levels are largely genetically determined (80-90%) and are elevated in about 20% of the population.
What does it assess?
Higher levels of Lp(a) have been strongly linked to cardiovascular disease and heart valve disease (aortic stenosis).As Lp(a) levels are predominantly genetically determined, there is no need at this point for most people to repeat the test more than once.
How do I optimize my Lipoprotein (a) levels?
Omega-3 fatty acids, particularly from fish oil, may have a modest effect in lowering Lp(a) levels in some individuals.While they are better known for their ability to reduce triglycerides and improve overall lipid profiles, certain studies suggest omega-3s can help reduce the risk associated with elevated Lp(a) by improving endothelial function and reducing inflammation. Since kidney disease can influence Lp(a) levels, maintaining kidney health may indirectly help manage Lp(a) levels.Adequate hydration, reducing excessive protein intake, and controlling blood sugar and blood pressure are critical steps in maintaining optimal kidney function.Additionally, addressing underlying conditions like diabetes, which can affect kidney health, can help lower the risk of complications from elevated Lp(a). Niacin (nicotinic acid), a B vitamin, has been shown to reduce Lp(a) levels in some individuals, though its use should be done under medical supervision due to potential side effects. High doses of niacin may lower Lp(a) by up to 30%, but it can cause flushing, liver toxicity, and other adverse effects, so careful monitoring is necessary.Niacin’s ability to raise HDL cholesterol while lowering Lp(a) makes it a valuable tool in managing lipid profiles for those with elevated Lp(a).
What do high and low Lipoprotein (a) levels mean?
While not everybody that has elevated Lp(a) is at very high risk, in general, higher Lp(a) levels indicate an inherited risk of heart attack, stroke and heart valve disease. As it is primarily genetically determined, healthy lifestyle does not lower Lp(a) significantly.Low Lp(a) levels indicate that with respect to Lp(a)-mediated genetic risk, you are not at increased risk of cardiovascular disease. As there are many other mechanisms of inherited cardiovascular risk, this does not rule out all genetic predispositions.
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