Today we're going to talk about a special type of cholesterol in our bodies. You may not have heard of it before. It's called lipoprotein (a), or Lp(a) for short. Since it's so important for our heart health, let's talk about it in a little more detail, shall we? Don't worry, I'll explain it to you in a simple way.
What is lipoprotein (a)? Simply put…
Okay, now let's see what this lipoprotein (a) is. Have you heard of ' bad cholesterol '? That's the type called `( LDL – Low-Density Lipoprotein)`. This `(LDL)` cholesterol is really not that good for our bodies. Do you know why? They get deposited inside our blood vessels , creating things like 'speed bumps' on the road. We medically call this ' plaque '. These 'speed bumps' cause blood flow to be blocked, like a traffic jam. Gradually, these get bigger and can completely block the blood vessels. That's when big problems arise.
Now this lipoprotein (a) is also a member of the ``(LDL)`` cholesterol family. However, this one is a little more troublesome . Why do I say that?
1. Lipoprotein (a) increases the risk of our blood clotting.
2. It also reduces the dissolution of blood clots .
Think about it, blood clots are like those 'speed bumps'. They obstruct the flow of blood. What's more, the inflammation caused by lipoprotein (a) makes those 'plaque' deposits more likely to break down. When they break down, more blood clots come and accumulate there. Do you understand the seriousness of the problem?
Is this lipoprotein (a) something we inherit from our genes?
Yes, that's right. Your lipoprotein (a) level is largely determined by the genes you inherit from your parents . That means the Lp(a) level you have when you're young will likely stay the same throughout your life. That's what makes it a little special. Unlike other types of cholesterol, it's hard to change this Lp(a) level much through things like what we eat and drink and how much we exercise.
How do I know my lipoprotein (a) level?
To find out, you need to do a special blood test . The Lipid Panel, which measures the types of cholesterol we all talk about (total cholesterol, LDL, HDL, triglycerides), does not include this Lp(a) test. Therefore, you will have to request this test separately from your doctor.
Why would a doctor want to check my Lp(a) level?
Not everyone has their Lp(a) level tested. However, if you already have other factors that increase your risk of heart disease, your doctor may suggest this test. What are those factors?
- If anyone in your family (mother, father, siblings) has heart disease or has had heart disease at a young age.
- If you have a genetic cholesterol-increasing disease called ``Familial Hypercholesterolemia''. About 30% of people with this condition also have high Lp(a) levels.
- If your last `(Lipid Panel)` test shows a very high `(LDL)` cholesterol level.
- If you or someone in your family has had coronary artery disease (a blockage in the arteries that supply blood to the heart) at a young age .
- If you continue to have cardiovascular events such as heart attack or stroke, even after controlling your risk factors.
- If someone in your family has already been confirmed to have high Lp(a) levels.
In cases like this, knowing your Lp(a) level can give you a clearer picture of your heart disease risk.
What things can affect my Lp(a) blood test results?
Yes, some things can cause slight variations in the results of the Lp(a) test. For example:
- Menopause is the period when a woman's menstrual cycle permanently stops.
- Some types of medications:
- Oral estrogen supplements.
- Niacin (a form of vitamin B3).
Therefore, if you are using these types of medications, it is best to inform your doctor before taking the Lp(a) test.
What is a normal level of lipoprotein (a)?
Generally, an Lp(a) level of less than 30 milligrams per deciliter of blood (`<30 mg/dL`) is considered the best and healthiest level.
Abnormal results are as follows:
- Borderline risk: Between 14 mg/dL and 30 mg/dL.
- High risk: Above 31 mg/dL and below 50 mg/dL.
- Very high risk: greater than 50 mg/dL.
Some researchers believe that measuring the number of lipoprotein (a) particles in the blood (`(nanomoles per liter – nmol/L)`) is more accurate than measuring it in `mg/dL`. In terms of particle count, anything above 100 nmol/L is considered high Lp(a) levels.
It's important to ask your doctor what units of measurement they use so you can understand your results accurately.
What does high lipoprotein (a) mean? What does it mean?
If your Lp(a) level is high, you are more likely to develop cardiovascular disease (`(Cardiovascular Disease)`) . This can sometimes happen even if your other cholesterol levels (like LDL and HDL) are at a good level. This means that Lp(a) is an independent risk factor.
Research has found a link between high levels of Lp(a) and the following diseases:
- Heart Disease
- Heart Attack
- Heart Failure
- Peripheral Artery Disease (PAD) – This is a blockage of the arteries that supply blood to the limbs.
- Aortic Valve Stenosis – Narrowing of a major valve in the heart.
- Stroke
- Coronary Artery Disease (`(Coronary Artery Disease)`)
This is why it is important to be concerned about Lp(a).
How common are high Lp(a) levels?
Worldwide, it is estimated that one in five people (about 20%) have high Lp(a) levels . This means that it is not that rare.
What are the symptoms of high lipoprotein (a)?
Many people have high Lp(a) levels but don't show any symptoms . That's the danger of this. It can cause damage inside the body without any warning. However, if someone in your family has this condition, ask your doctor if it would be wise for you to get tested too.
So how do I lower my lipoprotein (a) levels?
This is a problem that many people have. To be honest, there are currently no specific medications approved by the US Food and Drug Administration (FDA) that can directly lower lipoprotein (a) levels. Researchers are continuing to research this and are trying to find new drugs.
But, that doesn't mean there's nothing we can do. There are many things you can do to keep your overall heart health in good shape. Even if your Lp(a) levels don't directly lower, these things can help reduce your risk of heart disease.
- Stop using tobacco products completely. Smoking is very bad for the heart.
- Exercise regularly. Do something like walking, running, or swimming for at least 30 minutes a day.
- Maintain a healthy weight that suits you.
- Eat a heart-healthy diet. Eat more vegetables, fruits, legumes, whole grains, fiber, and fish (especially oily fish like salmon and mackerel). Reduce oil, salt, and sugar. Reduce processed foods and fast foods as much as possible.
- Keep your blood pressure and diabetes (Diabetes Mellitus) well controlled. These are major risk factors for heart disease.
- Use medications as directed by your doctor to control your LDL cholesterol levels.
- Manage stress in daily life. Things like meditation, yoga, and hobbies can help.
What can the doctor do to lower my Lp(a) level?
Doctors may prescribe certain medications to treat high Lp(a) levels. For example:
- Statins (These are drugs that mainly lower LDL cholesterol, and may not have much effect on Lp(a)).
- `(PCSK9 inhibitors)` (This is also a new type of cholesterol-lowering medication, which can reduce Lp(a) levels to some extent).
- Aspirin (a medicine that reduces blood clotting, may be recommended in some cases).
However, these medications do not significantly reduce Lp(a) levels, which is why researchers are trying to find other treatments.
In very rare cases, your doctor may use a procedure called ``Apheresis.'' This removes lipoprotein (a) from your blood. It's similar to dialysis, which removes waste products from your blood when your kidneys are not working properly. However, this treatment is only available to people with ``Familial Hypercholesterolemia.'' This treatment takes at least three hours and needs to be done once a week or every other week. So it's not something everyone does every day.
You may feel a little overwhelmed by all this cholesterol. That's normal. If your doctor is talking about lipoprotein(a), don't be afraid to ask questions to make sure you understand exactly why it's important to you. You and your doctor should have a good discussion about your risk of heart disease when determining your risk. Then you can work with your doctor to change the things you can change and lower your risk.
Final Take-Home Message
Okay, let's now recall some of the most important points from what we've talked about:
- Lipoprotein (a), or Lp(a), is a special type of cholesterol that we inherit genetically and that increases the risk of heart disease .
- This is not measured by a standard cholesterol test (`(Lipid Panel)`); a special blood test is required.
- If you have a family history of heart disease, have had heart disease at a young age, or have other risk factors, talk to your doctor about getting your Lp(a) tested.
- People with high Lp(a) levels often do not show symptoms .
- Although there are currently no approved drugs that directly lower Lp(a), it is very important to make lifestyle changes (healthy diet, exercise, smoking cessation) that improve overall heart health and control other risk factors (LDL, blood pressure, diabetes).
- Talk openly with your doctor about your Lp(a) level and the risks associated with it.
Remember, being aware of your health is the best way to stay healthy. Don't be afraid, seek out the necessary information, and follow your doctor's advice. Then you can live a healthy life even with these conditions.
` Lipoprotein (a), Lp(a), cholesterol, heart disease, genes, blood test, heart attack, stroke, health
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