Lp(a): A risk factor you should know about

Have you heard of Lp(a)? It’s short for lipoprotein(a), and it could increase your risk of aortic stenosis and other heart conditions. “Elevated Lp(a) is the most powerful risk factor for aortic stenosis. Everybody should have their Lp(a) measured at least once in their lifetime,” says Dr. Philippe Pibarot, Director of Cardiology Research at the Quebec Heart and Lung Institute, and a board member of Heart Valve Voice Canada.

What is Lp(a)?

It’s one of the proteins in your blood that carry cholesterol and other fats around your body. Lp(a) — pronounced “lipoprotein little a” or “L-P-little-a” — shares some similarities with its better known sibling, LDL, often called “bad” cholesterol.

Why does Lp(a) matter?

Elevated Lp(a) levels in your blood can increase your risk of aortic stenosis and put you at higher risk of heart attack, heart failure and stroke.

How does Lp(a) become elevated?

It’s determined by your genes. By the time you were five years old, your Lp(a) level was established; for most people, it remains stable throughout their life. An estimated one in five people has elevated Lp(a).

How do I know if I have elevated Lp(a)?

There are no symptoms, and Lp(a) is not included in routine blood tests.

So, you need to ask your doctor or clinic to arrange a blood test for Lp(a). This is recommended by the Canadian Cardiovascular Society, and you only need to be tested once. There may be a cost for the test, if it is not covered by your provincial health plan.

According to international guidelines, it’s even more important to get your Lp(a) level tested if any of these apply to you:

  • You have aortic stenosis

  • You experienced a heart attack or stroke

  • A close blood relative had a premature heart attack or stroke (under age 55 for men, and under age 65 for women)

  • A close blood relative has been diagnosed with elevated Lp(a)

  • You have a family history of high cholesterol (familial hypercholesterolemia)

  • You’ve had recurrent heart attacks despite taking statins to reduce cholesterol.

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

If a blood test shows you have elevated Lp(a) — defined as levels higher than 50 mg/dL (500 mg/L) or 120 nmol/L — you’ll want to discuss this with your healthcare provider.

It’s important to make healthy lifestyle choices, such as eating a healthy diet and getting regular physical activity. These can help reduce your cardiovascular risk over all, even though they will not change your level of Lp(a).

Your healthcare provider may refer you to a cardiologist or other specialist with expertise in Lp(a).