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Imagine your cholesterol numbers as characters in the story of your heart health.
The villain — low-density lipoprotein (LDL) — sticks to arterial walls. It potentially restricts blood flow, leading to heart attacks and strokes. Meanwhile, the hero — high-density lipoprotein (HDL) — swoops in to save the day, carrying LDLs away from your arteries so they remain clear.
Now imagine the villain has a trouble-making sidekick called lipoprotein(a), or Lp(a) (it's pronounced "L P little a"). It clings to LDL and, in some people, can be found in high levels that heart experts now associate with the following health problems:
While diet and exercise may help control run-of-the-mill LDL cholesterol, these healthy behaviors appear to have little impact on Lp(a). That's why doctors at Rush are looking at ways to protect their patients from the damaging effects of high levels of Lp(a) — and it starts with raising awareness about this little-known yet serious threat.
Research indicates that one in five people have high levels of Lp(a). It often passes from one generation to the next undetected. "Lp(a) can go undiagnosed because doctors don't routinely test for it when checking your cholesterol," says Annabelle Volgman, MD, cardiologist and director of the Rush Heart Center for Women.
"In our practice, we'd see patients under 50 having heart attacks who didn't have significant risk factors and were baffled," Volgman says. "We wondered 'Why so young?' "
So Volgman and her team started performing advanced lipid testing to look for abnormalities. And they found that many of their patients had elevated Lp(a) levels. "In women we tested, more than 40 percent had high levels."
That's why Volgman advises keeping an eye out for important risk factors when it comes to Lp(a):
If you have any of these risk factors, talk to your doctor about having a blood test for Lp(a) when testing cholesterol, Volgman says.
While diet and exercise may help control run-of-the-mill LDL cholesterol, these healthy behaviors appear to have little impact on Lp(a).
Some doctors may be resistant to extra testing because there's currently no established treatment for lowering Lp(a) levels. But many, like Volgman, believe equipping patients and their doctors with this information can be incredibly valuable for these reasons:
While there aren't currently any medications that have the power to lower Lp(a), researchers are looking at new therapies to specifically target Lp(a) levels.
Until those are available, Volgman strongly encourages you to be the hero of your heart health story: If you have a family member who has suffered a heart attack, stroke or blood clots prior to age 50, talk to your doctor about Lp(a) blood testing.
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