Lp(a) – another fat that is bad for our heart

July 1, 2010 by  

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Another bad fat has been identified to be bad for our heart. And we should get tested for it, according to experts.

The European Atherosclerosis Society (EAS) has recent issued new guidelines regarding cardiovascular screening. The group issued a consensus statement recommending testing for elevated levels of Lp(a), which stands for lipoprotein(a). The recommendations are meant for patients with high to moderate risk of cardiovascular disease. This is in addition to the current practice of screening for total, LDL- and HDL cholesterol and triglycerides. The upper limit for Lp(a) is 50 mg/dL.

So what is this bad new fat Lp(a)?

“Lp(a) is a plasma lipoprotein consisting of a cholesterol-rich LDL particle with one molecule of apolipoprotein B-100 and a molecule of apolipoprotein A. About 20% of people are thought to have plasma Lp(a) levels over 50 mg/dL; there are no gender differences in Lp(a) concentrations, but racial differences have been observed, with whites and Asians having lower levels while black and Hispanics generally have somewhat higher levels.”

Although scientists have been aware of the dangers of Lp(a) and it being a risk factor for cardiovascular disease, it is only now that it is included in clinical screening guidelines. The EAS based their recommendations on evidence from recent clinical studies.

According to consensus panel cochair Dr John Chapman:

“We consider the level of evidence to be sufficient to warrant the identification of Lp(a) as a causal, independent cardiovascular risk. So that raises the ante on Lp(a) very considerably from its position over the past five or 10 years. [There have been] a series of publications, both epidemiological and genetic, over the past two years that have really clarified the evidence base around Lp(a) and its role as a risk factor.”

How can Lp(a) levels be controlled?

Unlike in the case of cholesterol and other lipids in the blood, Lp(a) is not greatly influenced by lifestyle factors, making it almost a non-modifiable risk factor. Aside from the recommendation to screen, the EAS also recommends the use of niacin or nicotinic acid at a daily dose of 1 to 3 g to control and lower Lp(a) levels under 50 mg/dL.

The new EAS recommendations were presented at the EAS 2010 Congress in Hamburg, Germany last month.

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