Neurologist Dr. Priyanka Sehrawat emphasizes that normal cholesterol levels do not necessarily indicate low heart attack risk, highlighting two key markers—ApoB and Lipoprotein(a)—as stronger predictors of cardiovascular events, especially in individuals with a family history or metabolic dysfunction.
Lipoprotein(a), or Lp(a), is a genetic particle linked to increased cardiovascular disease risk, affecting one in five people globally. Despite its significant impact, Lp(a) is not widely tested due to the lack of approved treatments, though this is changing with new drugs in development. Experts recommend testing for Lp(a) as part of cardiovascular risk assessment, especially for those with a family history or other risk factors, to encourage lifestyle changes that can mitigate overall heart disease risk.
Lipoprotein(a), or Lp(a), is a genetic particle linked to increased cardiovascular disease risk, affecting 1 in 5 people globally. Despite its significant impact, Lp(a) is not widely tested due to the lack of treatment options, though this is changing with new drugs in development. Experts recommend testing for Lp(a) to better manage overall heart health, especially for those with a family history of heart disease or other risk factors. Awareness and testing are crucial as Lp(a) levels are not influenced by lifestyle changes like LDL cholesterol.
Recent research suggests that the traditional understanding of cholesterol and its impact on cardiovascular health may be incomplete. While statins have been effective in lowering LDL cholesterol levels, they do not address other problematic cholesterol types such as lipoprotein(a) and remnant cholesterol. New medications targeting these cholesterol types are being researched, with the hope of reducing the risk of cardiovascular disease. Additionally, the role of HDL cholesterol is more complex than previously thought, and efforts to raise its levels have not shown significant health benefits. The emerging consensus is to minimize non-HDL cholesterol for better cardiovascular health.
Lipoprotein(a) (Lp(a)), a protein that can significantly increase the risk of heart attack when present in high levels in the blood, is often overlooked as a red flag for heart disease. Lp(a) causes atherosclerosis, inflammation, and increases the risk of clotting, making it a triple threat. Despite its prevalence and impact on cardiovascular health, only a small percentage of Americans have had their Lp(a) levels checked. While there is currently no therapeutic available to reduce Lp(a) levels, it is still important to test for it as it can help identify individuals at higher risk and allow for the mitigation of other cardiovascular risk factors. Researchers are actively studying Lp(a) and developing potential therapeutics to reduce its risk in the future.
In a promising early trial, the experimental drug muvalaplin has shown the ability to reduce levels of lipoprotein(a) (Lp(a)), a molecule linked to cardiovascular disease, by up to 65%. Lp(a) is known to clog blood vessels and is difficult to reduce through diet or medication. Muvalaplin disrupts the formation of Lp(a) and was found to be well-tolerated with no serious adverse effects. Further clinical trials are underway to determine the drug's overall efficacy and long-term risks.