Heart and cholesterol

Lipoprotein(a)

Lp(a), "lipoprotein little a"

Included in every MyHealthspan membership: Focus, Baseline, and Complete.

Lp(a) is a heart risk factor set mostly by genes.

Lp(a) is a cholesterol-carrying particle whose level is mostly set by your genes. A higher level is linked with greater risk of heart attack, stroke, and narrowing of the aortic valve (aortic stenosis), even when your other cholesterol results look good.

Canadian guidelines recommend measuring Lp(a) once in your lifetime.

Lp(a) looks like an LDL particle with an extra protein attached. Because your level is largely inherited, it stays fairly stable through adulthood, and a standard cholesterol panel doesn't include it.

Knowing your result helps a clinician judge your overall risk. If your Lp(a) is high, it can be a reason to manage the factors you can change, such as LDL cholesterol and blood pressure, more closely.

Lp(a) is mostly inherited, so one measurement is usually enough.

Questions

Can I lower my Lp(a) with diet or exercise?

Lifestyle changes have little effect on Lp(a). They still matter, because improving your other risk factors lowers your overall risk. A clinician can talk with you about how to approach a high result.

Does a high Lp(a) mean I'll have heart disease?

No. It means your risk is higher than it would otherwise be. Your overall risk depends on the whole picture, including blood pressure, LDL cholesterol, smoking, diabetes, and family history.

Should my family be tested?

Because Lp(a) runs in families, a high result can be useful information for parents, siblings, and children. Expert groups such as the European Atherosclerosis Society suggest that close relatives of someone with high Lp(a) consider testing too.

Sources and references