Lipo a

[Jcmainfinity]

Does anyone have high lipo a? I just found out I do and it’s genetic!! It’s a huge factor in heart disease and stroke. Apoe4/4 and now this:(

[NF52]

Does anyone have high lipo a? I just found out I do and it’s genetic!! It’s a huge factor in heart disease and stroke. Apoe4/4 and now this:(

It does sometimes seem like the bad actors decided to travel in groups, doesn't it!

Here's a post from just a few days ago about Lp(a), (sometimes referred to on podcasts as "LP,little a" to distinguish it from LDL-C (total LDL cholesterol) and LDL-P (the total number of LDL-particles).

Oxidized phospholipids as a unifying theory for lipoprotein(a) and cardiovascular disease

Like you, I have both high Lp(a) (mine tested at 175 about 18 months ago) and high LDL-P. My father died of cardiac arrest at the age of 67, (my age now) and had aortic stenosis, a hallmark of Lp(a) along with coronary artery disease. So I was, to put it mildly, "freaked out" by the results of the test I had ordered online.

My doctor spent a lot of time talking with me about the rapidly developing state of research into Lp(a), which he described as "fascinating", because we don't yet know which people with high Lp(a) are also moving towards clinical signs of heart disease. He predicted that within 5 years the field will be much richer with studies. He also pointed outthat as a non-smoker, non-diabetic, non-obese woman whose family history does not include heart attacks in men before the age of 55, or in women before the age of 65, I appear to have protective factors. But he also supported my plan to get a coronary calcium scan, which he had to request, but which my insurance wouldn't cover. (It was about $ 150). The CT is painless and quick and the results were reassuring: I was at the 0%ile for coronary plaque compared to women my age, and the report gave me a coronary age of "39". I doubt that means I'll live another 50 years, but it did reassure me that I wasn't at imminent risk of serious heart problems.

At the age of 35, with your exercise and healthy eating, I imagine your heart is also happy and healthy. If you have a family history of early heart disease, you may want to talk to your doctor about this. But like ApoE 4, you have time to continue your wonderful habits, enjoy your children and wait for the research and clinical practice to learn more. If 20% of the population carries these genes, it's not the whole story, because 1 in 5 people don't have heart attacks in their 40's and 50's.

Here's an overview of Lp(a), which explains how it seems to highly inherited (about 20% of the population carries a gene that contributes to high Lp(a), and the "number" doesn't seem to vary much over the course of a person's lifetime: Understand Inherited Lipoprotein(a)

[BrianR]

Does anyone have high lipo a? I just found out I do and it’s genetic!! It’s a huge factor in heart disease and stroke. Apoe4/4 and now this:(

Yep, I'm an Lp(a) overachiever.

The https://www.lipoproteinafoundation.org/ site that NF52 linked to is a great resource. You may also want to skim this recent article: NHLBI Working Group Recommendations to Reduce Lipoprotein(a)-Mediated Risk of Cardiovascular Disease and Aortic Stenosis.

This twitter thread from Lp(a) expert Sam Tsimikas on Niacin and Lp(a) may be of interest: https://twitter.com/Lpa_Doc/status/1118957744940171265. Tsimikas' company Ionis recently licensed their antisense drug to lower Lp(a) to Novartis and should be starting phase 3 trials soon: https://ir.akceatx.com/news-releases/ne ... -exercises

[NF52]

Does anyone have high lipo a? I just found out I do and it’s genetic!! It’s a huge factor in heart disease and stroke. Apoe4/4 and now this:(

Yep, I'm an Lp(a) overachiever.

This twitter thread from Lp(a) expert Sam Tsimikas on Niacin and Lp(a) may be of interest: https://twitter.com/Lpa_Doc/status/1118957744940171265. Tsimikas' company Ionis recently licensed their antisense drug to lower Lp(a) to Novartis and should be starting phase 3 trials soon: https://ir.akceatx.com/news-releases/ne ... -exercises

Thanks for the added info, BrianR! I also like the idea of reframing high Lp(a) as being an “overachiever”!

The Stage 3 trial by Novartis of people with actual CVD and high levels of Lp(a) sounds promising. Since Stage 2 demonstrated safety in two doses, the Stage 3 trial will probably be longer to also demonstrate continued safety and actual reduction of cardiac “events.”

Well worth mentioning to APOE4 folks who have Lp(a) and current CVD.

[Jcmainfinity]

My grandpa has his arteries in his neck cleared because of so much plaque. He had a heart attack at 45!!!He didn’t excersice and didn’t eat the healthiest, but I’m guessing that’s where that gene came from:( BUT my dad hasn’t had any issues and he’s 62, so I’m HOPING that means I don’t have to take after my grandpa. My moms side is super healthy and in their 90’s.
It’s just upsetting and I’m so thankful for you guys. The past 2 weeks, man, I’m just not the same person.
NF52, have you always had high lipo a since it seems to be a determined factor already? I have been reading on CoQ10...... it seems like it could reduce it......

[NF52]

NF52, have you always had high lipo a since it seems to be a determined factor already? I have been reading on CoQ10...... it seems like it could reduce it......

I’ve only had the one test, but it seems we’re born with a stable number. Your grandpa gave you at most 25% of his genes. My son’s grandfather was bald at 25, but my sons have great hair. You’re gonna be okay, sweetie!

[KatieS]

I think NF52 is correct that we will have a much better understanding about lp(a) in a few more years; since I suspect there is multiple types of lp(a), the larger size perhaps not so pathogenic. Like Jcmain, I was quite upset with a lp(a) of 205 on Quest and 75 on LabCorp until I had my 101 y/o 3/4 mom's LabCorp result of 76. She had a mild stroke at 100 which she only has the residual of slight arm weakness, slower reading and learning new things. She has escaped cancer and heart disease, still exercises three times a week at the senior center. If you do not developed heart disease, having a high lp(a) is associated with longevity. However, she has been on anti-hypertensives and low-dose simvastatin for decades, although her cholesterol has never been ideal despite statins. Stanford has tested her cognitively and MRI, so she has signed the arrangement for brain autopsy after her death.

[Jcmainfinity]

How were those measured? 205-75 is a big difference....
I read it can be nmol/L OR something else ...on my lab 75 or less is normal if measured nmol/L

[NF52]

How were those measured? 205-75 is a big difference....
I read it can be nmol/L OR something else ...on my lab 75 or less is normal if measured nmol/L

Can't speak for Katie S, but my report was by LabCorp, so the 178 definitely put me in BrianR's "overachiever club". LabCorp's website states this for their Lp(a) test:

values ≥75 nmol/L may indicate independent risk factor for CHD.

https://www.labcorp.com/test-menu/30481/lipoproteina#

So KatieS and her 100 year old mother are on the cusp of higher risk, but I think her point is that as Lap Corp also states, the risk varies

depending on the presence of other risk factors.

And I would add, other protective factors. Anyone who is 100 with no clinical signs of heart disease has some good health habits and genetic protective factors, I would guess.

I think the current best advice for those of us with high numbers is to avoid the big, obvious risk factors, and let our primary care providers know about this and any family history so you can have a discussion of the need for extra monitoring of heart health.

[Jcmainfinity]

I was just kind of confused of her lab difference.. I use quest and they measure the same way so a reading of 205 and then 75 is a pretty drastic drop.