Did you know that around 1 in every 5 people may be walking around with an unknown genetic risk for heart disease?
This worrying statistic comes from our recent client data where 18% of our users discovered this hidden threat lurking in their bloodstream. Our statistic coincides with the American College of Cardiology's estimation that 20-25% of the world's population has elevated Lp(a). The source of this hidden threat? A little-known substance called lipoprotein(a), also known as "L-P-little a" or Lp(a) for short.
Key Points:
- Lp(a) is a genetically determined lipoprotein that can increase heart disease risk 2-4 times when elevated.
- Although high Lp(a) is genetic, there are still various lifestyle changes you can make that can lower your chances of getting heart disease
- Lp(a) testing is recommended at least once in a lifetime, but it's not typically provided in standard Canadian healthcare
Lp(a) remains a mystery to many – even some healthcare professionals. Its unique properties and genetic component make it a subject of both fascination and concern within the medical community and worried individuals. As awareness grows, so do the questions surrounding this enigmatic particle. We wanted to address some of the biggest questions surrounding Lp(a) to clear up some confusion on this important yet often overlooked aspect of cardiovascular health.
What is Lp(a)?
Lp(a) is a low-density lipoprotein in your blood that functions similarly to the more commonly understood LDL cholesterol. Both molecules are used to transport cholesterol to areas of need through the bloodstream. The key difference between the two? Lp(a) is determined by genetics and can be even more dangerous.
Why is Lp(a) important?
Clinical studies have shown that individuals with high Lp(a) levels have a 2-4 times higher risk of heart disease compared to those with lower levels. Heart disease consists of heart attacks, strokes and a range of other cardiovascular conditions such as heart valve disease, aortic stenosis, and limited lower-body circulation. This makes Lp(a) testing crucial for cardiovascular risk assessment, especially for those with a family history of early heart disease.
Is Lp(a) genetic?
Unlike other heart disease risk factors such as age, diet, or inflammation, Lp(a) is largely controlled by a specific gene, called LPA on chromosome 6. Although genes normally fail to account for the full story in biology, Lp(a) levels have a very direct link to your genetic code.
If one of my parents has high Lp(a), does that mean I will as well?
As Lp(a) is primarily genetic if one of your parents has high Lp(a), you're more likely to have elevated levels too. However, a blood test is the only way to know for sure.
My dad died of a heart attack, could it have been from Lp(a)?
A heart attack can be triggered by a wide range of causes, it’s impossible to know if the exact cause was from high Lp(a). With that being said, if one of your parents has experienced heart disease in the past, it is advisable that you get your Lp(a) levels tested as early as possible so you can better understand the risks posed to your health going forward.
What Lp(a) level is too high?
Canadian guidelines have placed an upper limit of 50mg/dL (100nmol/L) as healthy. What’s important to note here about Lp(a) is that there is no clear ‘safe zone’. There is a linear trend that the greater the Lp(a) levels the greater the heart disease risk. For this reason, certain healthcare providers including ourselves, consider anything above 30mg/dL (75 nmol/L) as elevated risk.
Can you lower your Lp(a)?
At the moment there is not a clear drug available in Canada that has been approved to specifically lower Lp(a). However, many pharmaceutical companies are working towards exploring new drugs and therapies to target Lp(a). A specific class of molecules called PCSK9 inhibitors, have been discovered to reduce levels to the tune of 30%; however, robust trials are still missing to confirm clinical benefit for cardiovascular disease. Another possible method that has been shown to decrease Lp(a) levels is a blood procedure called Lipoprotein apheresis. More information about this procedure can be found here.
I exercise every day, why is my Lp(a) so high?
Exercise, while beneficial for overall heart health, doesn't significantly affect Lp(a) levels. Your high Lp(a) is likely due to your genetic makeup rather than lifestyle factors.
Does diet affect your Lp(a)?
Like with exercising, there is little evidence that diet affects your Lp(a) levels. However, healthy lifestyle habits such as exercising and a strong diet can benefit other cardiovascular components, which can in turn reduce your risk of heart disease.
What other biomarkers function similarly to Lp(a)?
Although Lp(a) may seem like an unavoidable precursor to heart disease, optimizing other biomarkers that function similarly such as LDL cholesterol, HDL cholesterol, and ApoB can be beneficial. Additionally, managing inflammation markers like C-reactive protein (CRP) can help reduce overall cardiovascular risk.
What can people with high Lp(a) do to avoid their risk of heart disease?
While you can't easily lower your Lp(a) levels, there are many steps you can take to reduce your overall risk of heart disease:
- Maintain a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins.
- Exercise regularly, aiming for at least 150 minutes of moderate-intensity weekly activity.
- Quit smoking and limit alcohol consumption.
- Manage stress through relaxation techniques or mindfulness practices.
- Control other risk factors like high blood pressure, diabetes, and obesity.
- Discuss the use of statins or other preventive medications with your healthcare provider.
Why doesn’t Canadian healthcare test for Lp(a)?
Lp(a) is not routinely measured in traditional primary care practices despite current Canadian guidelines. For instance, The Canadian Cardiovascular Society recommends that Lp(a) levels be checked at least once in your lifetime. The typical Canadian physician will recommend getting only the standard lipid profile test, which often doesn’t include an Lp(a) measure. It is only once patients turn 50 years old when heart disease risk begins to significantly increase that physicians will recommend taking the specific blood test. Since intervening to lower Lp(a) has yet to be proven to diminish heart disease risk, the financial costs of offering Lp(a) tests to people below the age of 50 could outweigh the potential benefits for a national healthcare system. Although discovering high Lp(a) might not lead to immediate ways to lower it, the awareness from uncovering the risk earlier on could proactively motivate undergoing measures that could decrease overall heart risk.
Where can I get my Lp(a) levels tested?
Knowledge is power when it comes to your health – so don't let Lp(a) remain a secret threat to your well-being. Here at NiaHealth, we test for Lp(a) and many other key biomarkers that could extend your lifespan. Along with your Lp(a) metric you will receive a personalized step-wise action plan to support your health span and journey for longevity.
Don't let crucial health information slip through the cracks of traditional healthcare. Test for these essential biomarkers with NIA Health and embark on your Medicine 3.0 journey today! Take control of your health and longevity – because your future self deserves nothing less. Check our plans here!
NiaHealth stands out as a leading Canadian provider of comprehensive health insights. We analyze over 40 key biomarkers to give you a deep understanding of your body's current state. Based on these results, we create a personalized dashboard with tailored lifestyle recommendations. Our goal? To help you optimize your health, extend your health-span, and achieve your wellness objectives with precision and clarity.
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