Lipoprotein (a), Lp(a) cholesterol, is a type of low-density lipoprotein -- LDL, the "bad" cholesterol linked to high blood pressure and heart disease. Cholesterol and blood, like oil and water, don't mix well. To move through your bloodstream, fatty cholesterol must bond with protein molecules, forming a lipoprotein. Lp(a) is an LDL cholesterol molecule attached to a specific protein -- apo(a). The way Lp(a) works isn't fully understood, although there does seem to be a correlation between Lp(a) and atherosclerosis, narrowing and hardening of the coronary arteries, in both men and women.
Step 1
Have your Lp(a) level checked with a lipid profile blood test. Normal levels are below 20 mg/dL. Levels higher than between 20 and 30 mg/dL of Lp(a) are considered to be elevated and raise your risk of heart disease. If you have high total cholesterol, above 200 mg/dL with low HDL and high LDL levels coupled with elevated Lp(a) levels, your risk of having a heart attack is greater than if you only had a poor HDL/LDL ratio.
Step 2
Lower your Lp(a) cholesterol. Elevated Lp(a) levels seem to be caused by genetics, rather than lifestyle choices and may not respond as well to dietary changes as regular LDL cholesterol. Although statin drugs seem to have a limited effect on lowering Lp(a) levels, estrogen can lower Lp(a) levels by 20 percent in women, and niacin may lower Lp(a) levels by 30 percent in both men and women.
Step 3
Check your kidney function. Chronic kidney disease, kidney problems that leak protein into your bloodstream and patients on dialysis tend to have elevated Lp(a) levels. If your Lp(a) is caused by kidney disease, it may be more difficult to lower your Lp(a) level. Concentrate on raising your HDL -- the "good" cholesterol -- which works to clean your blood of all types of LDL cholesterol.
Tips and Warnings
- You may need more than a standard lipid profile to test your Lp(a) level -- a vertical auto profile, or VAP test, can categorize cholesterol by type and size, which may be a much more precise tool in predicting your risk of heart disease.
- Many factors determine your risk of developing heart disease -- elevated cholesterol is just one risk factor. Your doctor will be able to give you a better picture of your overall health.
