Lipoprotein (a): Important Indicator of your risk of heart attack or stroke or valve disease

Routine cholesterol testing often fails to identify important risk factors for heart disease, heart attacks or stroke. In fact, most cholesterol panels only measure of few types of cholesterol. Advanced lipoprotein (cholesterol) testing not only evaluates your cholesterol levels, but also looks for the presence of specific markers which are associated with a higher risk for cardiovascular disease.

Lp(a): What It Is and Why It’s Important To Check It

It’s well known that elevated cholesterol levels can increase your risk of cardiovascular disease which can lead to a heart attack or a stroke or aortic valve disease. Lp(a), while different from LDL, low density lipoprotein, is also considered a “bad form” of cholesterol. Due to its ability to promote inflammation in the walls of your arteries as well as calcification of your aortic valve, elevated Lipoprotein a (Lp(a)) levels are associated with an increased risk of serious cardiac events. Lp(a) is also genetically determined, making it an extremely important marker to evaluate if you have a family history of heart attacks or strokes at a young age.

Lp(a): How To Check It 

Tests that measure your levels of Lp(a) are available. However, they are generally not a part of standard cholesterol testing. Reliance on these routine cholesterol panels can lead to an incorrect assessment of your true risk of an adverse cardiovascular disease. For instance, it is possible for you have low or normal LDL levels as measured on routine cholesterol tests and, yet, have an elevated Lp(a) level.

Lp(a): What To Do If You Have Elevated Levels Of It

Elevated cholesterol is caused by several factors, including many lifestyle factors and, in some people, genes. Since Lp(a) is genetically determined, it’s important for you to put your genes in as healthy an environment as possible in order to lower your risk of a heart attack or stroke.

Diet is just one factor that can elevate cholesterol. Here, it’s important to recognize that not all fats are bad for you. In fact, omega 3 fatty acids – found in salmon, olives, nuts, and seeds – are anti-inflammatory and can lower cholesterol. These foods are found in abundance in the Mediterranean diet. Eating a diet that includes vegetables and fruits rich in soluble fiber – apples, artichokes, asparagus, banana, beans, berries, broccoli, Brussel sprouts, dark leafy greens, lentils, nuts, pears, peppers, and squash – also helps to lower cholesterol. 

An imbalance in your blood sugar levels can also create inflammation and, overtime, insulin resistance which can increase your cholesterol levels – especially triglyceride levels. Processed foods, especially those high in fructose corn syrup and simple carbs, can spike your blood sugar, resulting in increased triglyceride levels. Creating balanced meals from whole foods which include healthy proteins salmon, good fats and oils as well as good carbs (vegetables and fruits) can reduce inflammation and cholesterol levels.

Additional causes of elevated cholesterol include a lack of physical exercise, thyroid hormone imbalances as well as an unhealthy composition of gut bacteria which can contribute to inflammation and increased cholesterol levels. Heavy metal toxins such as mercury, certain chronic low-level infections, and certain medications have also been associated with elevated cholesterol levels. A Covid-19 infection has been shown to elevate cholesterol levels acutely and, in some people, for a longer period afterward. 

The functional medicine approach to cardiovascular and cardiometabolic health focuses on identifying what specific factors are elevating your cholesterol and addresses them. If you would like more information on advanced cholesterol testing or functional medicine, please contact us.

References

Duntas, A. Thyroid disease and lipids. Thyroid. 2002 Apr;12(4):287-93.

Durrington, P. Blood lipids after Covid-19 infection.The Lancet. Comment.2023 Feb; 11(2):68-69.

Kronenberg, F. et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J. 2022 Oct 14;43(39):3925-3946.

Lipoprotein (a) | CDC

Tall, AR & Yvan-Charvet, L. Cholesterol, inflammation and innate immunity. Nat Rev Immunol. 2015 February ; 15(2): 104–116.Zhang, J. et al. Lipoprotein (a) and myocardial infarction: impact on long-term mortality. Lipid Health Dis. 2023 Jun 9;22(1):70.