What is Lipoprotein Little a?
Lipoprotein little a (pronounced “L-P-little a” or Lp(a) for short) is a type of cholesterol particle in your blood that can increase your risk of heart disease. Think of Lp(a) as the evil twin of the familiar low-density lipoprotein (LDL) cholesterol, often referred to as “bad” cholesterol [1]. It’s similar to LDL but has an extra protein attached to it that makes it more dangerous.
It’s in Your Genes
The most important thing to understand about Lp(a) is that it’s genetic – you’re born with it [2]. Unlike regular cholesterol that changes with diet and exercise, your Lp(a) level is determined by your genes. If your parents or grandparents had high Lp(a), you might have it too, and if you have it, your children might also have it.
Why It’s Especially Important for South Asians
Approximately 25% of Indians and other South Asians have elevated Lp(a) levels – that means 1 in 4 of us have this problem! [3] When comparing different ethnic groups, Black people have the highest Lp(a) levels, followed by South Asians, then White people, Hispanics, and East Asians with the lowest levels [4].
For South Asians, the risk from high Lp(a) is more than double the risk observed in people of European descent [5]. This helps explain why heart disease is so common in our community.
South Asians, in general, develop heart attacks about 10 years earlier than other populations, and young South Asians have heart attack rates three to fivefold higher than other groups [6]. Many of us look healthy from the outside, with normal cholesterol and blood pressure, but might have high Lp(a) that we don’t know about.
Why Lp(a) is Dangerous
High Lp(a) promotes blood clotting and inflammation in your arteries, which increases your risk of heart attack, stroke, and other heart problems [7]. It contributes to the buildup of plaque in your arteries, narrowing them and restricting blood flow to your heart.
Why It’s Not Included in Regular Cholesterol Tests
Lp(a) isn’t picked up by a standard cholesterol test. You need a separate special blood test specifically for Lp(a) [8]. Until recently, many doctors didn’t routinely check for Lp(a) because there weren’t specific medications to treat it. But that thinking is changing.
What You Can Do About It
The good news is that knowing your Lp(a) level can help you and your doctor make better decisions about your heart health. If you have high Lp(a), your doctor might:
- Be more aggressive in treating your other risk factors like blood pressure and regular cholesterol
- Recommend earlier and more intensive use of cholesterol-lowering medications
- Monitor your heart health more closely
- Suggest lifestyle changes to reduce your overall heart disease risk
- Consider recommending testing for your close family members
One Key Takeaway: Ask Your Doctor for an Lp(a) Test
Next time you go for a checkup, especially if someone in your family had a heart problem before age 60, ask your doctor: “Can I get my Lipoprotein little a (Lp(a)) tested?” This simple question could help protect your heart!
Your health is in your hands. Knowledge is power.
References
- Harvard Health. (2023). The latest on lipoprotein(a), an inherited cause of early heart disease. Link
- American Heart Association. (n.d.). Lipoprotein (a). Link
- Enas et al. (2019). Lipoprotein(a): An underrecognized genetic risk factor for malignant coronary artery disease in young Indians. Indian Heart Journal. Link
- ScienceDirect. (n.d.). Lipoprotein(a) and ethnicities. Link
- PLOS One. (n.d.). Association of lipoprotein (a) with coronary artery disease in a South Asian population. Link
