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What Is Lipoprotein(a)?

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Updated February 24, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Lipoprotein(a) is a particle that is very similar to LDL, or “bad” cholesterol, except that the LDL cholesterol molecule has an apolipoprotein A molecule attached to it.

While the discovery of lipoprotein(a) isn't new, scientists are just beginning to scrape the surface of what it does in the body. There have been some studies suggesting that having high levels of lipoprotein(a) circulating in your blood could place you at a higher risk of developing heart disease.

What Does Lipoprotein(a) Do?

Lipoprotein(a) is made in the liver and then enters the bloodstream. Lipoprotein(a) has been shown to accumulate under the inner lining of arteries, which could contribute to the formation to atherosclerosis by promoting inflammation and the formation of foam cells.

Additionally, lipoprotein(a) also contains a component that is very similar to the blood clotting protein plasminogen. Because of this, lipoprotein(a) may contribute to blood clot formation.

Both of these functions can be a recipe for heart disease. However, the complete function of lipoprotein(a) is not fully known.

Although some studies have shown that having high lipoprotein(a) levels could place you at a higher risk of having heart disease, more studies are needed in order to further establish this relationship. In some of these studies, high lipoprotein(a) levels appeared to be most damaging when LDL cholesterol levels were also high.

What Levels of Lipoprotein(a) Are Considered Normal?

Lipoprotein(a) is not routinely measured in blood tests. Because scientists are just beginning to understand the role that lipoprotein(a) plays in causing heart disease, it is not known whether it will become a standard measurement of heart disease risk in the future.

The scale by which lipoprotein(a) is measured is not standardized, so there is no level that is considered to be normal. Because high levels of lipoprotein(a) are mostly inherited, quantifying and developing a standardized scale for measurement may be difficult.

How Can I Lower Lipoprotein(a) Levels or Prevent Them From Increasing?

Unfortunately, lipoprotein(a) levels are influenced mostly by genes, so diet, exercise, and most cholesterol-lowering medications do not have much effect on lowering them. Niacin has shown some promise in lowering lipoprotein(a) levels in studies, but because we are just beginning to understand how lipoprotein(a) affects heart health, this medication is not routinely used for that purpose.

If you are trying to lower your risk for developing heart disease, you should focus on reducing other, well-established risk factors for heart disease, such as lowering blood pressure, lowering LDL cholesterol, and raising HDL cholesterol. Multiple studies have shown that targeting these risk factors can help lower your risk of having a heart attack or stroke.

Sources:

Erquo S, Kaptoge S, Perry PL et al. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. JAMA 2009; 302:412-423.

Boffa MB, Koschinsky ML, Berglund L. Lipoprotein(a): a unique risk factor for cardiovascular disease. Clin Lab Med 2006;26:751-772.

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