February is American Heart Month, a time to shine a national spotlight on heart health. Yet many Americans know very little about lipoprotein (a), a key factor in potential heart disease. One of the reasons for this is that while the EHE Pulse Physical exam includes a lipoprotein (a) test, many primary care providers do not routinely administer the test. Watch Health Coach Adam explain more about lipoprotein (a) below.
About the lipoprotein (a) test
You may already be familiar with high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol. LDL, or “bad cholesterol,” can cause plaque buildup in your arteries, increasing your risk for heart disease. HDL, or “good cholesterol,” helps to protect your heart by sweeping away the LDL and associated plaque. Both of these are controllable, to some extent, through diet and exercise, as well as certain medications.
Lipoprotein (a) is a protein that transports cholesterol throughout your bloodstream. Like LDL, it can cause plaque buildup in your arteries. Unlike LDL, though, it is genetically inherited. Anyone can have a high level of lipoprotein (a), so it makes sense to get tested, especially if there is any history of heart disease or cholesterol issues in your family.
Blood testing for lipoprotein (a)
Learning your lipoprotein (a) level requires a simple blood test that is included in your EHE Pulse Physical exam. You don’t need to fast before this test unless you are having other bloodwork performed at the same time. Your doctor will let you know which tests to anticipate and whether you should fast.
Normal ranges
In general, a lipoprotein (a) test that shows above 50 is considered high. However, many experts believe that a level of 25-30 or lower is best. Your doctor will likely give you a target range based on your own unique medical profile. Note that there is no lower limit. Some people have very low or even undetectable levels of this protein. Unlike many of your body’s chemicals, lipoprotein (a) is not necessary for healthy functioning. So you only need to be concerned if you have a higher than normal level.
Risks associated with high levels of lipoprotein (a)
If you have elevated lipoprotein (a), you may be at higher risk for several conditions, including:
- Aortic stenosis
- Heart attack
- Peripheral artery disease
- Stroke
Your risks are increased if you have high lipoprotein (a) plus coronary artery disease or a family history of familial hypercholesterolemia (FH). This inherited condition makes it more difficult for your body to process LDL cholesterol.
Protecting your heart health
Because it is genetic, it is generally impossible to lower lipoprotein (a) in a meaningful way. There is a treatment known as lipoprotein apheresis, which is a sort of dialysis that filters out both lipoprotein (a) and LDL. However, it is in very limited use and generally offered only to certain people who have FH along with high lipoprotein (a) and LDL levels. New treatments are in clinical studies, but for now, you’ll need to focus on management techniques.
A heart healthy lifestyle is a good idea for everyone. For those with high lipoprotein (a) levels, it’s absolutely essential. You can do this by following the American Heart Association’s Essential 8:
- Healthier eating is a core component of heart healthy living. Focus on whole foods, fruits and vegetables, lean proteins, and healthy fats.
- Aim for at least 75 minutes of vigorous activity or 150 minutes of moderate activity each week.
- Eliminating tobacco use. Tobacco is a well-documented risk factor for a variety of illnesses. This includes vaping, which has been found to be no better than smoking.
- Adults generally need 7 to 9 hours of sleep per night, and a lack of sleep can contribute to many different ailments.
- Weight management. Everyone has a different ideal weight, so talk to your doctor about what is right for you.
- Cholesterol control. You can’t control your lipoprotein (a), but you can control your total and LDL cholesterol levels. Lowering your LDL while keeping up your HDL can help mitigate many of the risks of high lipoprotein (a).
- Blood sugar management. If you have diabetes or prediabetes, it’s extremely important to keep your blood glucose under tight control. High blood sugar levels over a long period of time can damage your heart as well as other organs.
- Controlling blood pressure. Optimal blood pressure is around 120/80, depending on your age, gender, and current medical status. The higher your blood pressure, the harder your heart has to work, so focus on keeping yours in a healthy range.
A high level of lipoprotein (a) is a risk factor for your heart, yet too many people have never been tested. Knowledge is power. When you know your number and track it over time, you can take active steps to mitigate its potential effects. With a heart healthy lifestyle, there is no reason that people with high lipoprotein (a) can’t live a healthy, normal life.