Understanding Lp(a): Risks and Management Strategies

Lp(a) poses significant cardiovascular risks, especially when levels exceed certain thresholds, making awareness crucial for prevention.

### Understanding Lp(a) and Its Impact on Cardiovascular Risk
Lp(a) is a subtype of LDL that carries an additional protein, **apoprotein(a)**, which is synthesized by the liver. Elevated levels of Lp(a) are linked to an **increased cardiovascular risk**, and these levels can be **inherited**. The video series aims to provide accessible information on Lp(a), its effects, and potential solutions for **managing its levels**.

### The Role of Lp(a) in Atherosclerosis
Lp(a) particles are a minority in LDL measurements but are **more atherogenic** due to the presence of **apo(a)**. High levels of Lp(a) are associated with a **greater risk of atherosclerotic events**, making it a significant genetic lipoprotein abnormality. Approximately **20% of the population** has high Lp(a) levels, and its concentration is important for assessing risk, with levels **above 30 mg/dL** indicating **potential trouble**.

### Understanding Lipoprotein(a) and Its Impact
Lipoprotein(a) levels may increase slightly during menopause but not enough to cause a **pathological change**. High lipoprotein(a) particle count doesn't significantly contribute to **apoB elevations**, making its impact on vascular events **unclear**. Testing for lipoprotein(a) can be done in three ways, with **nanomoles per liter** being the most accurate, and it's recommended to measure it **once** due to its **genetic stability**.

### Managing High Lipoprotein(a) Levels
High lipoprotein(a) is associated with **aortic calcification and stenosis**, making it a **significant risk factor for myocardial infarction and strokes**. While current drugs cannot effectively lower lipoprotein(a) levels, measuring **apolipoprotein B** and using **PCSK9 inhibitors** may help reduce **residual atherosclerotic risk**. New drugs targeting the synthesis of **apolipoprotein(a)** are undergoing clinical trials, aiming to provide a more effective solution for **lowering lipoprotein(a) particle concentrations**.

### The Future of Lipoprotein(a) Drugs
New drugs targeting lipoprotein(a) are in clinical trials and may take **several years to reach the market**. These drugs will likely be prescribed only for individuals with **significant atherosclerosis and high lipoprotein(a) levels**, limiting their availability for primary prevention. In the meantime, managing other major risk factors and using **PCSK9 inhibitors** can help lower lipoprotein(a) levels and reduce overall risk.

### Managing Lipoprotein(a) Levels
Saturated fat may lower lipoprotein(a) by **10-20%**, but its overall effect on risk and ApoB levels is questionable. Trans fats have a stronger impact, increasing lipoprotein(a) by **70%**, but are mostly banned in the US. There is no specific diet proven to manage lipoprotein(a), but a healthy diet can help with other major risk factors for cardiovascular health.

### Understanding Lp(a): Key Insights and Management Strategies for Cardiovascular Health
* 🩺 Today, we delve into **Lp(a)**, a crucial topic in cardiovascular health, with insights from Dr. Tom Dayspring, a seasoned expert in lipidology with **nearly four decades of experience**.
* 📊 Lp(a) is a subtype of LDL that carries an additional protein called **apoprotein(a)**, which can **increase cardiovascular risk**, especially when particle counts exceed certain thresholds, such as **30 mg/dL for mass** and **50 nmol/L for particle count**.
* 💡 Approximately **20% of individuals** have high Lp(a) levels, making it a **common but often overlooked risk factor** for atherosclerosis and related events like **heart attacks and strokes**.
* ⚠ While most labs measure Lp(a) in mass, the more accurate measure is in **nanomoles per liter**, where levels **above 125 nmol/L** are concerning, indicating a potential for **significant cardiovascular risk**.
* 💊 Currently, there are no existing drugs that can effectively lower Lp(a) to necessary levels, but **PCSK9 inhibitors may reduce Lp(a) by 20-30%** and are a potential option for those also needing to manage **ApoB levels**.
* 🥗 Dietary recommendations for Lp(a) management are limited, but maintaining a healthy diet can help control other risk factors like **ApoB and blood pressure**, which collectively **lower overall cardiovascular risk**.
* 🔬 Ongoing clinical trials are exploring new drugs specifically targeting Lp(a) reduction, but these may take years to become available, emphasizing the **importance of monitoring Lp(a) levels and managing other cardiovascular risk factors** in the meantime.
* 📅 For those interested in a deeper understanding, further resources and expert interviews are available for **more detailed insights into Lp(a) and its implications for health**.

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Everything you need to know about Lp(a) | ft. Dr. Tom Dayspring

Everything you need to know about Lp(a) | ft. Dr. Tom Dayspring