Lipoprotein(a) – Influenced by Genetics and Linked to Heart Disease

Lipoprotein(a) is a type of cholesterol we all have; however, it's not a cholesterol routinely monitored by physicians.  Typically you receive a standard lipid panel which gives you the following labs:

Total Cholesterol

LDL Cholesterol

HDL Cholesterol

Triglycerides (and maybe VLDL Cholesterol)

If the above labs are within normal, there is usually no reason a physician would order any further tests.  For those of you with a strong family history of heart disease, I encourage you to have your physician do routine tests beyond this standard lipid panel.  You need to have a comprehensive lipid panel.  A comprehensive lipid panel tests you for the following labs:

Total Cholesterol

LDL Cholesterol

HDL Cholesterol

Triglycerides

C-Reactive Protein (measure of inflammation)

Insulin

Homocysteine

VLDL Cholesterol

Remnant Lipoprotein

Dense LDL III

Dense LDL IV

Buoyant HDL 2b

LDL Phenotype/Size

Lipoprotein(a)

Now, several of these labs you're probably not familiar with and at some point I'll tell you more about them, but right now I want to focus on lipoprotein(a).

Lipoprotein(a) is formed when one LDL molecule is attached to a protein called apolipoprotein(a).  (FYI: Lipo = fat; hence the name lipoprotein - fat with protein.) A healthy level of lipoprotein(a) is beneficial and will:

Repair damaged cells

Restore structure of blood vessel walls

Enhance blood clotting

Prevent excessive blood loss due to damaged vessels

Promote cell regeneration

Basically, lipoprotein(a) at healthy levels acts as an "artery patch". 

On the flip side, elevated lipoprotein(a) causes problems.  If your vessel walls are damaged, the body produces more lipoprotein(a) to repair vessel walls.  Too much lipoprotein(a) concentrates at damage locations along your artery walls, binds with two amino acids resulting in LDL cholesterol being dumped at the "site" and oxidized LDL is deposited in the artery wall which escalates the build-up of plaque.  As the plaque forms, lipoprotein(a) encourages the formation of a blood clot on top of the plaque.  All of this acts to narrow the blood vessel and impedes blood flow.

One reason for elevated lipoprotein(a) levels is atherosclerosis (hardening of the arteries) and constant arterial wall damage causing the body to produce excess lipoprotein(a) in an attempt to repair the damage.  Another reason for high lipoprotein(a) levels is genetics.  Even if you do not have signs of heart disease, meaning your blood pressure and cholesterol levels are normal, you may still have elevated lipoprotein(a) due to genetics.

Lipoprotein(a) levels are not affected by the foods you eat or your activity level.  There are no prescription medications, including statin drugs, that have an impact on reducing levels.  That doesn't mean you don't have options if you live with an elevated lipoprotein(a).  Using supplements, such as omega 3's, niacin, and vitamin C are three options for reducing lipoprotein(a).