What is Lp(a)?

And what do I need to know about it?

Published March, 23 2023

You likely know the importance of checking your cholesterol regularly and that high cholesterol isn’t ideal. But did you know that Lipoprotein(a), or Lp(a), is one important lipid reading not included in most standard laboratory tests? Moreover, researchers have recently discovered that knowing your Lp(a) level is essential to understanding your risk for heart and blood vessel (cardiovascular) disease.

It’s estimated that 1 in 5 people (63 million globally) have high Lp(a).1 But because of the lack of testing, most people do not know if they have high Lp(a) and are at risk for cardiovascular disease until they have a heart attack or stroke.

Lp(a) and cholesterol tests

We make it easy to check your Lp(a) levels with the High-Risk Heart Health Lipid and Lp(a) Panel. It’s available to purchase online; no doctor’s visit is required. 

For a more complete picture, add the Cholesterol (Lipid) Panel to measure your total cholesterol, including HDL cholesterol (good), LDL cholesterol (bad), and triglycerides.

• Get the same quality lab tests doctors use from the world’s leading provider of diagnostic information services. All our tests help you uncover valuable insights about your health that you can discuss with your doctor.

What is Lipoprotein(a)?

Lipoproteins, or lipids, are fatty, waxy substances found in every cell of your body. Lipoprotein(a), or Lp(a)—pronounced “L-P-little-A,” is one of a group of lipoproteins that carry cholesterol through the blood. This group of lipoproteins also includes Low-Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL). 

Lp(a) looks like LDL cholesterol or “bad” cholesterol. But structurally, it has an extra apolipoprotein B attached to its surface. Lp(a) cholesterol is also “stickier” than LDL cholesterol and may be more likely to build up in the walls of your blood vessels, putting you at risk for cardiovascular disease (heart and blood vessel disease).

What are the signs or symptoms of high Lp(a)?

You may want to get tested if one or more of these apply to you:

• Family history of early onset heart or vascular disease 
• Elevated LDL cholesterol that doesn’t respond to medication
• Heart or vascular disease, with normal cholesterol and triglycerides without medication
• Think you may have inherited a genetic condition called familial hypercholesterolemia (FH)
• Have had more than 1 heart attack or procedure to open blocked arteries

How genetics and ethnicity play a role in Lipoprotein(a) levels

Lp(a) levels are tied to a specific gene in your DNA inherited from your parents. Lp(a) levels appear in your body by age five and remain the same throughout your life. While all ethnic groups are affected, Lp(a) is more common in African Americans and South Asians. Lp(a) levels may also rise in women and remain raised after menopause when estrogen levels decrease. Acute illness may also cause a temporary change in your level.

So, if you have a family member with a history of cardiovascular disease or high cholesterol, your Lp(a) levels may also be increased. Because Lp(a) levels are genetically determined, changes in diet or lifestyle cannot lower them.

What are the risks of having high Lipoprotein(a)?

Because Lipoprotein(a) particles are “stickier” than other types of bad cholesterol, they may be more likely to cause blockages and clotting. Research has shown that in people with high Lp(a), the risk for early heart disease and stroke is about 2-4 times higher than in the general population.(1) Despite the association between Lp(a) and heart attacks, checking the levels of Lp(a) flies under many doctors’ radars. This is in part because it is not as well-understood as other risk factors, and treatment options are still very limited.(4)

What does LP(a) do in the body?

Clotting- Lp(a) can cause increased clotting, leading to quickly formed blockages in blood vessels. The more Lp(a) plaques (fatty deposits) that build up, the greater the danger that a heart attack or stroke can occur.(2)

Inflammation- Lp(a) also promotes inflammation, increasing the likelihood that plaque deposits will burst. High Lp(a) levels can cause the narrowing of the aortic valve, called aortic stenosis, because of its role in inflammation. This chronic inflammation can also cause calcium buildup on the aortic valve, reducing blood flow.(2)

Medical conditions that may result from high Lp(a):

• Heart attack
• Stroke
• Coronary artery disease (narrowing/blocked arteries in the heart)
• Peripheral artery disease (blocked arteries in legs and arms) 
• Other conditions that affect the blood vessels 

No doctor visit is required to buy your own lab test at questhealth.com. PWNHealth and its affiliates review your purchase to ensure its medically appropriate before submitting the test order for processing. PWNHealth also reviews your test results and will contact you directly if they require prompt attention. Included in each purchase is the option to discuss your test results with an independent physician; however, you are also encouraged to speak with your primary healthcare provider. 

References

1. Making Sense of Lp(a). Silence Therapeutics. Accessed March 3, 2023. https://silence-therapeutics.com/patients/cardiovascular-disease-with-high-lipoproteina/making-sense-of-lpa/default.aspx
2. Reyes-Soffer G, Ginsberg HN, Berglund L, Duell PB, Heffron SP, Kamstrup PR, et al. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arterioscler Thromb Vasc Biol 2022; 42(1):e48-e60.

Sources

1. Khan, T. Z., Bornstein, S. R., & Barbir, M. (2019). Lipoprotein(a): the underutilized risk factor for cardiovascular disease. Global cardiology science & practice, 2019(2), e201911. https://doi.org/10.21542/gcsp.2019.11
2. What Are the Risks of FH and High Lipoprotein(a). Family Heart Foundation. Accessed March 7, 2023. https://familyheart.org/risk-with-fh-and-high-lpa
3. Diagnosing High Lipoprotein(a). Family Heart Foundation. Accessed March 7, 2023. https://familyheart.org/diagnosing-high-lipoproteina
4. Making Sense of Lp(a). Silence Therapeutics. Accessed March 7, 2023. https://silence-therapeutics.com/patients/cardiovascular-disease-with-high-lipoproteina/making-sense-of-lpa/default.aspx
5. Lipoprotein(a). Family Heart Foundation. Accessed March 7, 2023. https://familyheart.org/high-lipoprotein-a-101
6. Lipoprotein(a) Blood Test. National Library of Medicine: Medline Plus. Accessed March 7, 2023. https://medlineplus.gov/lab-tests/lipoprotein-a-blood-test/
7. What Are the Risks of FH and High Lipoprotein(a). Family Heart Foundation. Accessed March 7, 2023. https://familyheart.org/risk-with-fh-and-high-lpa
8. Lipoprotein(a). Centers for Disease Control and Prevention. Last Reviewed June 27, 2022. Accessed March 7, 2023. https://www.cdc.gov/genomics/disease/lipoprotein_a.htm
9. Weishaupt, Jeffrey. What is a Lipoprotein(a) Test? Last Reviewed November 5, 2021. Accessed March 7, 2023. https://www.webmd.com/heart-disease/what-is-lipoprotein-test
10. Treating High Lo(a). Family Heart Foundation. Accessed March 7, 2023. https://familyheart.org/treating-high-lpa 
11. Lipid Testing. Family Heart Foundation. Accessed March 7, 2023. https://familyheart.org/lipid-testing
12. Cholesterol Levels. National Library of Medicine: Medline Plus. Accessed March 7, 2023. https://medlineplus.gov/lab-tests/cholesterol-levels/
13. Lipoproteins. Cleveland Clinic. Last Reviewed May 22, 2022. Accessed March 7, 2023. https://my.clevelandclinic.org/health/articles/23229-lipoprotein
14. Diagnosing High Lipoprotein(a). Family Heart Foundation. Accessed February 14, 2023. https://familyheart.org/diagnosing-high-lipoproteina