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The genetic roots of Lipoprotein(a)

The genetic roots of Lipoprotein(a): Why lifestyle changes may not improve your levels

15.MAR.2024

Written by Anna Sanniti Medically reviewed by Dr. Zara Fullerton

Lipoproteins are round particles made of protein and fat that exist in your bloodstream. Lipoprotein(a), otherwise known as Lp(a), is a different type of low-density lipoprotein (LDL) produced by the liver. Lp(a) is similar to other types of LDL cholesterol, except that it has an extra protein which makes it stickier. This stickiness makes it more likely to form blood clots or even create blockages by building plaques. ¹

Unlike your total cholesterol, LDL, and high-density lipoprotein (HDL) levels, your Lp(a) levels cannot be controlled by diet and lifestyle interventions because your levels are almost entirely determined by genetic factors. ²

In this article, we will delve into:

  • The genetics of high Lp(a)

  • The effects of diet and lifestyle changes on Lp(a) and overall cardiac risk

  • What should I do if I have high Lp(a)?

The genetics of high Lp(a)

Having high Lp(a) levels is almost entirely determined (up to 90%) by genetic factors. ² It is estimated that around 20% of people worldwide have high Lp(a) levels. ³ Having high Lp(a) levels can increase cardiovascular disease risk by 2–3 times compared to people with Lp(a) within the normal range. ²

High Lp(a) is seen in people of all races and ethnicities but appears to be more common in Black people. ⁴

The effects of diet and lifestyle changes on Lp(a) and overall risk of cardiovascular disease

While it’s true that the primary cause of high Lp(a) relates to variations in the genes you inherit, healthy diet and lifestyle habits can still have a significant impact on reducing your risk for cardiovascular disease overall. Making positive changes to your diet and lifestyle and working with your healthcare provider to manage conditions such as diabetes and high LDL cholesterol can significantly reduce the risk of heart disease.

What should I do if I have high Lp(a)?

Testing provides you with the information that you need so that you can discuss your options with your healthcare provider. ⁴

It’s important to share your results with your healthcare provider, as they can provide guidance based on your situation. 

For some people, treatments such as Lipoprotein apheresis may be recommended. Other steps include reducing LDL cholesterol levels if they are high. Your healthcare provider will be able to provide guidance based on your individual situation. ⁴

Although high Lp(a) levels cannot be improved by healthy eating and exercise, it’s still important to maintain a healthy lifestyle and to work with your healthcare provider to manage other conditions such as high blood pressure and diabetes to reduce your overall risk of heart disease. ⁴

As high Lp(a) levels run in families, if your Lp(a) levels are high, you should talk to your healthcare provider for their recommendations for testing other members of your family. ⁴

Let’s recap

  • Lp(a) levels are almost entirely determined by your genes.

  • Healthy diet and lifestyle habits cannot improve your levels of Lp(a), but will still affect LDL cholesterol levels and have a profound impact on your cardiac risk overall.

  • If you have high Lp(a), consult your healthcare provider and discuss the result with your family members.

  • Testing is the most reliable way to know your Lp(a) levels.

  • To check your levels, order your cholesterol test online today.

Please note that the following is for educational use only and is not a substitute for medical advice. This content cannot diagnose or provide information about treatment. Consult with your healthcare provider if you have any concerns or need specific medical advice relating to any symptoms, conditions, diagnosis, or treatment. Do not delay seeking medical advice and do not disregard professional medical advice based on this content. Your healthcare provider can provide the most suitable guidance based on your situation.

References

1. Medline Plus: Lipoprotein (a) Blood Test. Online: medlineplus.gov2. Centers for Disease Control and Prevention. About Lipoprotein (a). Online: Cdc.gov3. Indian Heart Journal: Lipoprotein(a): An independent, genetic, and causal factor for cardiovascular disease and acute myocardial infarction. Online: sciencedirect.com 4. Center for Disease Control and Prevention. Lipoprotein (a). Online: cdc.gov5. Journal of Clinical Lipidology: Use of Lipoprotein(a) in clinical practice: A biomarker whose time has come. A scientific statement from the National Lipid Association. Online: lipidjournal.com