Lipoprotein(a)
An Overlooked Risk Factor for Cardiovascular Diseases and the Importance of Early Detection
Why should one measure Lipoprotein(a)?
Heart attacks and strokes are often the result of arterial calcification (atherosclerosis). In addition to known risk factors such as high blood pressure, smoking, and high LDL cholesterol levels, there is another important but often overlooked factor: Lipoprotein(a), or Lp(a). This blood value is rarely determined routinely but plays a crucial role in the early detection and prevention of cardiovascular diseases.
Lp(a) is a hereditary factor, whose levels are largely genetically determined and therefore can hardly be influenced by diet or exercise. About 20% of the population have elevated Lp(a) levels, often without knowing it. Therefore, a one-time measurement can help to identify an increased risk at an early stage.
How does an elevated Lp(a) level affect cardiovascular risk?
Lp(a) is similar to LDL cholesterol (the so-called "bad" cholesterol) but has an additional protein component: Apolipoprotein(a). This makes Lp(a) particularly dangerous because it:
- promotes deposits in the arteries and accelerates the formation of atherosclerotic plaques.
- Enhances inflammatory processesthat weaken the stability of the vessel walls.
- Affects blood clotting, which increases the risk of blood clots (thromboses) and thus for heart attacks and strokes.
Studies show that an Lp(a) level above 50 mg/dl significantly increases the risk of cardiovascular diseases. Levels above 180 mg/dl can even multiply the risk – comparable to a severe form of familial hypercholesterolemia.
Lp(a) as a marker for early detection
Since Lp(a) is a lifelong constant value , a single measurement is sufficient to estimate the individual risk. The determination is particularly important for:
- people with unexplained cardiovascular diseases in the family
- patients who have had early heart attacks or strokes despite good LDL levels
- individuals with recurrent vascular occlusions or aortic valve calcification
Especially in younger patients, where no classic risk factors are present, an elevated Lp(a) value can be a crucial indicator.
Are there ways to lower Lp(a)?
Since Lp(a) is strongly influenced by genetics, lifestyle changes alone are not sufficientto lower the value.Classic cholesterol-lowering medications like statins show no significant effect on Lp(a). However, there are promising approaches in research:
- New medications like Pelacarsen (antisense therapy) and Lepodisiran (siRNA therapy) specifically lower Lp(a) by up to 80%.
- Lipoprotein apheresis is already used in severe cases and can mechanically filter Lp(a) from the blood.
Conclusion: Measure Lp(a) – A Simple Test with Great Significance
Although Lp(a) is an underestimated risk factor, early detection can save lives. Those who know their personal risk can take targeted preventive measures and discuss suitable actions with doctors. A simple blood test is sufficient to provide clarity – especially for people with a family history or unclear cardiovascular events.
More information on Lp(a) and current research findings can be found, among others, at the German Heart Foundation (herzstiftung.de) and in professional publications such as Trillium Diagnostics (trillium.de).
