Everything you need to know about your Lipoprotein(a) blood test

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.