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What is Lipoprotein(a), and why does it increase your risk of heart disease?

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What is Lipoprotein(a), and why does it increase your risk of heart disease?

15.MAR.2024

Written by Anna Sanniti Medically reviewed by Dr. Zara Fullerton

There are many factors associated with an increased risk of heart disease such as high LDL cholesterol. However, there is another type of molecule found in the bloodstream, called Lipoprotein(a), also known as Lp(a), that isn’t as commonly tested for and could be playing a key role in this risk. 

It is estimated that roughly 20% of people worldwide have high Lp(a) levels [1]. What does this mean for understanding our cardiovascular disease risk? 

In this article, we will try to understand more about Lp(a) by discussing:

  • What is Lp(a)? 

  • Why do people have high levels of Lp(a)?

  • How does Lp(a) impact the risk of cardiovascular disease? 

What is Lp(a)?

Lipoproteins are round particles made of protein and fat that transport cholesterol through the bloodstream to cells around your body. 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. ²

Why do people have high levels of Lp(a)?

Unlike your total cholesterol, LDL, and high-density lipoprotein (HDL) levels, your Lp(a) level cannot be controlled by diet and lifestyle as it is almost entirely determined by your genetics (up to 90%).⁴ However, this does not mean that people with high Lp(a) should not practice good diet and lifestyle habits, as this can help reduce your overall risk of heart disease. 

You can read more about the genetics of Lp(a) here.

How does Lp(a) impact the risk of cardiovascular disease?

Understanding the amount of Lp(a) is important, as it can impact your risk of cardiovascular disease. 

Whatever your level of LDL cholesterol, high Lp(a) can increase cardiovascular disease risk by 2–3 times compared to people with Lp(a) within the normal range. ⁴ As Lp(a) contributes towards plaque buildup and the likelihood of clotting, high levels can put patients at an increased risk of developing heart disease and stroke. Lp(a) is also known to promote inflammation, making plaques more likely to rupture. ⁵ However, it is important to remember that having high Lp(a) levels does not guarantee that you will develop cardiovascular disease. Similarly, it is possible to develop cardiovascular disease when you have normal Lp(a) levels.

In addition to understanding your Lp(a) levels, your unique cardiovascular disease risk is based on many other factors, including ⁶

  • High blood pressure

  • Smoking

  • High cholesterol such as high LDL cholesterol

  • Diabetes

  • Physical inactivity

  • Being overweight or obese

  • Family history of cardiovascular disease

  • Ethnic background

The most reliable way to know if you have high Lp(a) levels is to get tested so that you can work with your healthcare provider to reduce your cardiovascular disease risk.

Let’s recap

  • Lp(a) is a type of LDL, but is stickier so is more likely to form blood clots and create blockages by building plaques.

  • Your Lp(a) level is almost entirely determined by your genes.

  • Lp(a) makes up part of your LDL cholesterol reading when you receive your blood cholesterol results. Understanding the amount of Lp(a) is important, as high levels can significantly increase your risk of cardiovascular disease, especially if you have other risk factors.

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. 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 2. Medline Plus: Lipoprotein (a) Blood Test. Online: medlineplus.gov 3. American Heart Association. What is atherosclerosis? Online: heart.org 4. Indian Heart Journal: Lipoprotein(a): An independent, genetic, and causal factor for cardiovascular disease and acute myocardial infarction. Online: sciencedirect.com 5. Center for Disease Control and Prevention. Lipoprotein (a). Online: cdc.gov 6. NHS. Cardiovascular Disease. Online: NHS.uk