Lipoprotein(a): Why you should know this blood value

Lp(a) level – never heard of it? But LDL and HDL, right? It's widely known that blood lipids and cholesterol levels influence heart health. Now, another piece has recently been added to the board: lipoprotein(a), abbreviated Lp(a).

Since it has been recognized that young heart attack patients often subsequently detect significantly elevated Lp(a) levels, it has been considered an important marker for cardiovascular complications, such as heart attack or stroke . "This is especially true for younger women and men and when no classic risk factors are present," emphasizes Prof. Dr. Thomas Voigtländer, Chairman of the Board of the German Heart Foundation. Approximately one in four to five people in the population has these elevated Lp(a) levels.

The good, the bad and the even worse blood lipids

Experts therefore recommend that we all have our lipoprotein(a) levels checked at least once in our lives. Why?

A brief overview: HDL ( high-density lipoprotein , mnemonic: "Love you") is the good fat molecule, while LDL ( low-density lipoprotein ) is the "bad" cholesterol, which is the one that damages blood vessels. Elevated LDL levels have been shown to cause blood fats to build up in the blood vessel walls, leading to arteriosclerosis (hardening of the arteries) and thus to heart disease. The following values are considered ideal for healthy women:

• Total cholesterol: less than 190 mg/dl (5.0 mmol/l)
• HDL: below 50 mg/dl (1.3 mmol/l)
• LDL: below 116 mg/dl (3.0 mmol/l)
• Lp(a): below 30 mg/dl

Lipoprotein(a) is something like LDL cholesterol, only worse because it contains a particularly damaging component: apolipoprotein A – hence the small a in parentheses. It "causes double damage to the blood vessels," explains cardiologist and author Dr. Catharina Hamm : "Lp(a) has a pro-inflammatory effect, increases blood clotting, and promotes the formation of plaque."

Important factor in the prevention of heart disease

According to the German Heart Foundation , more than 90 percent of the Lp(a) concentration in the blood is genetically determined and remains roughly constant throughout life. This means that it cannot be significantly influenced by dietary changes or exercise. While medications that lower Lp(a) are not yet available, clinical trials are underway, and approval is expected in the coming years. Dr. Catharina Hamm says initial results show that they can reduce elevated Lp(a) levels by up to 80 percent.

The great advantage of determining Lp(a): It allows high-risk patients to be identified , even if their LDL levels are completely normal. These individuals can then reduce their overall risk of cardiovascular disease by

• have heart checks done early,
• give up smoking,
• exercise regularly,
• eat healthily,
• keep an eye on your blood pressure
• and avoid being overweight.

Because high Lp(a) levels are inherited, there is a valuable opportunity for early prevention even in childhood in affected families: "If the risk is identified in a child with familial hypercholesterolemia (Editor's note: a lipid metabolism disorder with elevated blood lipid levels) , it can now be completely reduced to the risk of the general population with modern medications, without compromising their quality of life," explains Prof. Dr. Ulrich Laufs, Director of the Department of Cardiology at Leipzig University Hospital.

Brigitte

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