Lp(a) cholesterol: The hidden heart risk factor you should know about

STATEN ISLAND, N.Y. — A largely unknown genetic cholesterol marker that can indicate an elevated risk of heart disease or stroke is being inadequately explored, according to a Staten Island cardiologist whose passion is prevention.

Dr. Supreeta Behuria, of Northwell Staten Island University Hospital’s Preventive Cardiology Program in Ocean Breeze, wants people to know about the hidden cholesterol particle called Lp(a).

Many have never even heard of it, the doctor says.

When it comes to cholesterol, most people focus on their “good” (HDL) and “bad” (LDL) numbers, according Behuria.

But she’d like to raise awareness about the other cholesterol particle, which is equally important, that could be quietly raising your risk for heart attack or stroke — lipoprotein(a), or Lp(a).

Women and men

According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death in women in the U.S., and 60 million women in the U.S. — that’s 44% — are living with some sort of heart disease, its most recent statistics show.

It’s also the leading cause of death among men, with over 350,000 male deaths attributed to it annually, the CDC says.

Yet, women are underrepresented in research and risk assessment, according to Behuria. And Lp(a) has emerged as an important, but inadequately explored, risk factor in women’s heart health, she said.

While these gaps are particularly concerning for women, Lp(a) can affect anyone, so it’s important for both women and men to have their blood checked.

“Your Lp(a) level is determined almost entirely by genetics, you can’t lower it with diet or exercise alone,” said Behuria, co-director of preventive cardiology at SIUH. “That makes early testing and risk assessment essential.”

Knowing you have a higher risk is critical, she said.

“Knowing what your risk is will encourage you to change your lifestyle,’’ she said. ”And just increasing your own awareness about your own cardiovascular risk will keep you motivated to keep a heart-healthy diet and exercise. That’s the whole point in doing the testing now.“

Lp(a) is similar to LDL cholesterol but has an added protein called apolipoprotein(a), which makes it more likely to contribute to plaque buildup in arteries, trigger inflammation, and promote blood clots.

It is an independent and causal risk marker, strongly linked to early atherosclerotic cardiovascular disease, heart attack, stroke, aortic stenosis, and peripheral artery disease, the doctor said.

An estimated one in five people has elevated Lp(a), yet it remains widely underdiagnosed, she said.

Testing is simple. A blood test, often done alongside a standard cholesterol panel, can measure your Lp(a) level. It is only necessary to have the test once. The tests are covered by insurance, depending upon a person’s plan, she said.

Testing is especially important for people with a family history of early heart disease, those whose LDL cholesterol hasn’t responded to medication, and individuals who have experienced a heart attack or stroke before the age of 65, she said.

Lp(a) levels below 30 mg/dL are considered healthy, while levels above 50 mg/dL are linked to a higher risk of heart problems.

“Even though we can’t change your genetics, we can change how we manage your overall heart risk,” Behuria explained. “The sooner we know your Lp(a) level, the more we can do to protect you.”

For more information about SIUH’s Preventive Cardiology Program, call (833) SI-HEART.

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