High lipoprotein(a)
5.0 on GoogleHigh levels of lipoprotein(a) also known as Lp(a) can silently increase your risk of heart disease. Take control of your heart health and learn more about the condition, as well as how we can check your Lp(a) levels.
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Having high lipoprotein(a) levels can be concerning. However, the team and I stay at the forefront of the latest treatments and will work closely with you to ensure you get the best possible care and support for your heart health.
Dr Ravi Assomull, Consultant Cardiologist and Founder
Video FAQs
View our short videos designed specifically to answer your questions
Summary
Dr Ravi Assomull discusses the implications of having high Lipoprotein(a) and how it can increase the risk of serious cardiovascular conditions such as heart attacks, strokes, and early onset aortic stenosis.
Transcript
If you have a high lipoprotein A or LP it increases your risk of cardiovascular disease including heart attacks, strokes. It also increases your risk of developing premature valve disease, specifically a condition called aortic stenosis.
Summary
Dr Ravi Assomull outlines who should consider testing for Lipoprotein(a), including those with a family history of premature cardiovascular disease, individuals with unexplained high cholesterol, and patients diagnosed with early aortic stenosis. Knowing if you have elevated Lp(a) can guide more targeted cardiovascular prevention strategies.
Transcript
The people who should have their lipoprotein A checked are those who have a family history of premature cardiovascular disease, those who have a family history of a raised LP(a), those who have cholesterol levels that are proven difficult to treat, or those who have been diagnosed with a condition called aortic stenosis at a young age.
Summary
In this brief explanation, Dr Ravi Assomull provides clear guidance on what Lipoprotein(a) levels are considered low or high risk. He explains that levels below 75 nmol/L are generally seen as low risk for cardiovascular disease, while levels above 125 nmol/L indicate high risk. Understanding your Lp(a) number can help in assessing long-term heart health.
Transcript
A lipoprotein A level of less than 75 nmL is considered low risk, whereas a lipoprotein A level of greater than 125 nmol/L is considered high risk.
Summary
Dr Ravi Assomull explains that Lipoprotein(a) levels are largely inherited and are typically established by the age of five. While levels do not fluctuate significantly over time, conditions such as kidney disease or hormonal changes, including menopause, may cause slight variations. This video offers insight into the genetic nature of Lp(a).
Transcript
Well, your lipoprotein A levels are actually genetically determined and your particular level are set by the time you're five years old. They won't fluctuate as you age, but certain factors such as kidney disease, hormone replacement therapy or menopause may change them slightly.
Summary
In this video, Dr Ravi Assomull explains that a simple, one-time blood test is all that is needed to measure Lipoprotein(a) levels. Since these levels are set early in life and remain stable, routine repeat testing is not necessary unless future treatments require it. This video offers a clear overview of the diagnostic process.
Transcript
LP(a) levels are measured with a simple blood test. Now as the levels don't vary during a lifetime, you need to have that blood test just once.
Summary
Dr Ravi Assomull explains that Lipoprotein(a) levels are genetically determined and remain stable throughout life, meaning only one blood test is typically needed. He also discusses how future therapies may require ongoing monitoring if new treatments become available. This video is a helpful guide for understanding how Lp(a) is tracked over time.
Transcript
High LP(a) levels need just one blood test during your lifetime. This is because the levels don't vary with time. In the future there are likely to be drugs that reduce this and at that point serial blood tests should be considered.
Summary
In this video, Dr Ravi Assomull outlines the current limitations in lowering Lipoprotein(a), noting that lifestyle changes and most available medications have minimal effect. He discusses the modest impact of PCSK9 inhibitors and emphasizes the importance of addressing other cardiovascular risk factors such as LDL cholesterol, blood pressure, weight, and physical activity to reduce overall heart disease risk.
Transcript
Lipoprotein A levels can't be lowered by drugs or lifestyle modification currently. There is a modest effect with a certain type of drug called a PCSK9 inhibitor. However, there are many ways of reducing your cardiovascular risk, and these include reducing your LDL levels by conventional therapies such as statins, managing your blood pressure, adopting a heart healthy diet, maintaining a healthy weight, and taking plenty of exercise.
Summary
Dr Ravi Assomull discusses the current challenges in treating high Lipoprotein(a). While PCSK9 inhibitors may provide a modest reduction, there are no widely available therapies yet. However, several promising drugs are in clinical trials that may significantly lower Lp(a) levels in the coming years. This video highlights where we are today and what lies ahead.
Transcript
Currently there are no recognised treatments for high LP(a). Certain drugs such as PCSK9 inhibitors have a very modest level in reducing your LP(a) levels, but actually the real promise lies in current trials which have drugs that have been shown to reduce your LP levels by 80%. These should become available in the next three or four years.
Summary
Learn how to reduce cardiovascular risk with high Lp(a): lower LDL, manage blood pressure, eat a Mediterranean diet, exercise, quit smoking, and limiting alcohol to no more than 14 units per week.
Transcript
The main focus in terms of cardiovascular risk reduction in those with high LPA, including treating conventional risk factors such as your LDL with established treatments such as statins, managing your blood pressure with lifestyle modification and drug therapy if required, focusing on a heart healthy diet such as the Mediterranean diet, adopting a balanced and vigorous exercise program comprising resistance training, aerobic cardiovascular training, as well as isometric stretch exercises including yoga and Pilates. Avoiding smoking is critically important and moderating alcohol intake so you have no more than 10 to 15 units a week also confers protection against cardiovascular disease.
Summary
Dr Ravi Assomull explains why statins are not effective in lowering Lipoprotein(a) and how they may even slightly increase its levels. He highlights promising new therapies currently in development that have shown the potential to reduce Lp(a) by up to 80 percent in early clinical trials. This video offers valuable insight into what patients with high Lp(a) can expect in the near future.
Transcript
Statins don't actually lower lipoprotein A. They may actually reduce the size of the lipoprotein A molecule, but conversely can increase lipoprotein A a smidge. The real promise lies in drugs that are currently in development that have been proven in the early stages of these trials to lower lipoprotein A levels by up to 80%. We envisage that these should be available in the next 3-4 years.
Summary
Dr Ravi Assomull discusses why testing for Lipoprotein(a) is important, who should get tested, and how it impacts heart disease risk. He also explains current treatment options and how to reduce overall cardiovascular risk.
Transcript
If you're watching this video you've probably been referred to have your LP(a) blood test. Lipoprotein A or LP(a) is a cholesterol particle that closely resembles LDL or bad cholesterol but with an added protein called apolipoprotein A. This makes LP(a) more harmful as it promotes inflammation, interferes with clot breakdown and accelerates plaque buildup in the arteries. It does this by making the bad cholesterol more sticky to the vessel wall. Critically LP(a) levels are genetically determined and remain stable over a lifetime. About one in five people have elevated LP(a) which significantly increases the risk of premature heart attacks, strokes and aortic valve disease even if other cholesterol levels are normal. So who should have their LP(a) tested? People would benefit from having this blood test include those with a family history of premature cardiovascular disease, those with a family history of a raised LP(a), those who have been diagnosed with familial hypercholesterolemia, those in whom their cholesterol levels are proving difficult to treat, those who have developed aortic stenosis at a young age. Because levels don't fluctuate much a one-time blood test is typically sufficient unless you're charting treatment or part of a clinical trial. Unfortunately statins don't reduce LP(a) and may even raise it slightly. But promising new drugs are in clinical trials and have shown over 80% reductions in LP(a). These may become available in the next few years. In the meantime the key is to minimise overall cardiovascular risk, keep LDL cholesterol nice and low, manage blood pressure, avoid smoking, maintain a healthy weight, exercise regularly and follow a heart-healthy diet. While these don't directly reduce LP(a), they can significantly reduce the harm it causes.
Book your consultation with Dr Ravi Assomull today
Looking after your heart is the most important thing you can do to improve your longevity and quality of life in the long term.
We’re here for you during your journey to better heart health. We provide tests and management strategies to help identify what might be wrong and where you can improve your lifestyle to reach prime heart health.
Book an appointment today to speak to our expert Integrative Cardiologist, Dr Ravi Assomull, about your heart concerns.
You can email us at: enquiries@cardiologist.london
Or call us at: 020 3576 2885
Frequently asked questions
Short answers from Dr Ravi Assomull, consultant cardiologist - each one is also available as a video.
What does it mean when your Lipoprotein(a) is high?
Dr. Ravi Assomull discusses the implications of having high Lipoprotein(a) and how it can increase the risk of serious cardiovascular conditions such as heart attacks, strokes, and early onset aortic stenosis. Watch Dr Assomull's answer (0:18).
Who should have Lipoprotein(a) checked?
Dr. Ravi Assomull outlines who should consider testing for Lipoprotein(a), including those with a family history of premature cardiovascular disease, individuals with unexplained high cholesterol, and patients diagnosed with early aortic stenosis. Knowing if you have elevated Lp(a) can guide more targeted cardiovascular prevention strategies. Watch Dr Assomull's answer (0:24).
What should my Lipoprotein(a) level be?
In this brief explanation, Dr. Ravi Assomull provides clear guidance on what Lipoprotein(a) levels are considered low or high risk. He explains that levels below 75 nmol/L are generally seen as low risk for cardiovascular disease, while levels above 125 nmol/L indicate high risk. Understanding your Lp(a) number can help in assessing long-term heart health. Watch Dr Assomull's answer (0:16).
What causes Lipoprotein(a) to go up?
Dr. Ravi Assomull explains that Lipoprotein(a) levels are largely inherited and are typically established by the age of five. While levels do not fluctuate significantly over time, conditions such as kidney disease or hormonal changes, including menopause, may cause slight variations. This video offers insight into the genetic nature of Lp(a). Watch Dr Assomull's answer (0:21).
How is high Lipoprotein(a) diagnosed?
In this video, Dr. Ravi Assomull explains that a simple, one-time blood test is all that is needed to measure Lipoprotein(a) levels. Since these levels are set early in life and remain stable, routine repeat testing is not necessary unless future treatments require it. This video offers a clear overview of the diagnostic process. Watch Dr Assomull's answer (0:14).
How often should I be monitored if I have high Lipoprotein(a) levels?
Dr. Ravi Assomull explains that Lipoprotein(a) levels are genetically determined and remain stable throughout life, meaning only one blood test is typically needed. He also discusses how future therapies may require ongoing monitoring if new treatments become available. This video is a helpful guide for understanding how Lp(a) is tracked over time. Watch Dr Assomull's answer (0:19).