Hidden Blood Lipid Lp(a) Linked to Stroke, Heart Disease Risk

A hidden blood lipid, known as Lp(a), could be the reason some individuals experience strokes or heart disease despite maintaining a normal weight and having regular cholesterol levels. This genetically influenced lipid, found in about one in five people, often goes undetected by standard health screenings.

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Some people have normal diets, are not overweight, and have no high cholesterol problems, yet still suddenly have a stroke or heart disease. Foreign doctors point out that a "hidden blood lipid" called Lp(a) may be one of the reasons.

Lp(a), or lipoprotein(a), shares a similar structure with LDL cholesterol but possesses an additional protein. Researchers believe this may facilitate fat buildup in blood vessels and increase the risk of blood clots. Major studies and international medical guidelines now recognize Lp(a) as a significant risk factor for cardiovascular diseases. Unlike common cholesterol, Lp(a) is primarily hereditary, with genetics accounting for 70% to 90% of its variation. Consequently, diet, weight loss, or exercise typically have minimal impact on its levels.

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Lp(a) is closely related to genes, and about one in five people have high levels, but most people have no symptoms and it does not appear in general cholesterol tests.

Elevated Lp(a) levels are associated with a higher risk of cardiovascular disease, which can be further amplified by conditions like high LDL cholesterol, hypertension, diabetes, or smoking. While statins, a common cholesterol-lowering medication, show limited effectiveness and can even slightly increase Lp(a) in some patients, they remain crucial for managing overall cardiovascular risk.

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The structure is similar to low-density lipoprotein (LDL), commonly known as "bad cholesterol," but with an additional special protein.

Several pharmaceutical companies are developing novel therapies, including gene-silencing techniques, to reduce Lp(a) production in the liver. Early clinical trials suggest these new drugs could lower Lp(a) concentrations by 80% to 90%. Because Lp(a) is not part of routine cholesterol checks, a separate blood test is required. International guidelines suggest considering at least one Lp(a) test for individuals with a family history of early-onset heart disease or those who develop cardiovascular issues despite a healthy lifestyle. Experts emphasize that while genetics play a role, managing other risk factors like LDL cholesterol, maintaining exercise, avoiding smoking, and controlling blood pressure and blood sugar are still vital for protecting heart health.

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Lp(a) is mainly determined by genes, with 70% to 90% of the variation related to genetics, so even improving diet, losing weight, or increasing exercise usually makes it difficult to significantly lower the value.