LDL is not the only “Bad” Cholesterol: What you Should Know About Lp(a)

Joseph Freedman Cardiologist Cape Coral, FL

Dr. Joseph Freedman has many years of experience as a cutting-edge cardiologist who specializes in the prevention, diagnosis, and treatment of cardiac diseases. Dr. Freedman was trained at the well-known Cleveland Clinic, which has been continuously ranked as #1 in Cardiovascular Care, where he focused on cardiac imaging.... more

A genetically inherited cholesterol, Lp(a) is what tennis player Arthur Ashe had, as well as the Biggest Loser’s, Bob Harper. Lipoprotein (a) increases the risk of heart disease and cardiovascular conditions greatly. Cardiac Care Group endorses the following information provided by the Lp(a) Foundation to shed light on this genetic disorder.

According to the Lipoprotein(a) Foundation, Lp (a), is a particle in your blood that carries cholesterol, fats, and proteins. The amount your body makes is inherited from one or both parents and is determined by the genes passed on from your parent(s) when you are born. It does not change very much during your lifetime except if you are a woman, levels increase as the natural estrogen level declines with menopause. Diet and exercise seem to have little to no impact on the lipoprotein(a) level. Some cholesterol and Lp(a) in your blood is normal. A high level of LDL-cholesterol increases your risk of a heart attack or stroke.1

Lipoprotein(a) is a type of lipoprotein/cholesterol and high levels increase your risk for atherosclerosis (buildup of fatty deposits in the wall of the artery, also called atherosclerotic cardiovascular disease or CVD) including coronary heart disease (blockages in your heart arteries) or heart attack,  peripheral vascular disease (PAD, blockages in the leg arteries), aortic stenosis (damage to the aortic valve of the heart), thrombosis (blood clots) and stroke (blockages in the neck arteries). In children, a high level of Lp(a) is a leading risk factor for strokes but strokes are very rare in any child, even those with a high level of Lp(a).1

About 20% or one in five people have high levels of Lp(a) greater than 50 mg/dL (500 mg/L) from birth based on genetic factors they inherited from their parents, and most don’t know they have it. As high levels of Lp(a) travel through the bloodstream, it collects in the arteries, leading to gradual narrowing of the artery that can limit blood supply to the heart, brain, and kidneys as well as the legs. It can increase the risk of blood clots, heart attack, heart failure, peripheral artery disease/amputation or stroke.1

Reasons an Lp(a) test may be right for you 1

  • You or a family member have had a heart attack or stroke at an early age including circulation trouble in the legs and/or narrowing of the aorta. For men, it would be younger than 55 years of age and women less than 65 years of age.
  • Someone in your family has high Lp(a). If an adult has high Lp(a), their children have a 1 in 2 chance of inheriting it.
  • Heart attack or stroke with no other known risk factors such as smoking, high LDL, or “bad” cholesterol, diabetes, or obesity. An estimated 50% of people who have heart attacks have normal levels of LDL-cholesterol.
  • High LDL-cholesterol levels even while taking statins or other LDL lowering medications.
  • Having FH (Familial Hypercholesterolemia), an inherited condition of very high LDL cholesterol levels.1       

What can you do about your lifestyle? 1

  • People with high Lp(a) appear to benefit from good fats in their diet from nuts, fish, avocado, and olive oil. 
  • Aim for at least 30-60 minutes of moderately vigorous physical activity every day.
  • Stop smoking. 
  • Control your weight.  
  • If you drink alcohol. Limit yourself to 1 drink per day for women (none if you have a personal or strong family history of breast cancer) and 2 drinks per day for men.
  • Manage stress with regular physical activity and relaxation exercises such as yoga or meditation.1

What about medications and procedures? 1

  • It is important to manage all your other risk factors.  
    • High LDL cholesterol or triglycerides
    • High blood pressure
    • High blood sugar/diabetes
  • There isn't a medicine available that just lowers high Lp(a) yet. The good news is that lowering all your other risk factors may lower your overall risk of a heart attack or stroke.
  • Medicines called statins only lower LDL cholesterol.
  • Niacin is sometimes used to lower Lp(a). It can also lower LDL cholesterol. Talk with your doctor before taking over-the-counter niacin.
  • Ask your doctor about the benefit of taking a 81 mg coated aspirin per day to combat the blood clot risk from high Lp(a).1

Advanced pharmaceutical trials are underway for Lp(a); however, Cardiac Care Group will work with you to customize a treatment plan that’s most beneficial for you.   

Cardiac Care Group is proud to serve the residents of Southwest Florida with the most comprehensive, specialized cardiac health care available. We work hard to exceed the needs of our patients and referring physicians. Our cardiology services cover a vast continuum of care, from prevention and early detection to the latest in cardiovascular treatment.

Please Call Cardiac Care group Today at 239-574-8463.



1. https://www.lipoproteinafoundation.org/page/UnderstandLpa