High Levels of This Inherited Protein May Cause Heart Attack, Stroke

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There’s a widely unknown inherited risk factor for heart attack and stroke that’s imperative to know about, especially if you have a family history of these ailments.

Lipoprotein(a) is another factor that should be checked at the doctor along with cholesterol and blood pressure, according to researchers with the Baylor College of Medicine. It’s also considered to be one of the strongest factors and can even be at the root of health problems, said Christie Ballantyne, a professor of Medicine and the Chief of the Cardiology section of Baylor, in a press release.

“Most people are aware of the common risk factors – smoking, diabetes, high cholesterol and blood pressure, and family history. We are finding that lipoprotein(a), called Lp(a), should be added to that list, especially if you have a family history of heart attack or stroke,” Ballantyne said. “Studies have shown that high levels of Lp(a) are not just associated with a higher risk of cardiovascular issues, but can be the cause.”

Blood tests and genetic testing can check for Lp(a) levels because the protein is inherited. There are no current solutions for keeping Lp(a) levels in check, either.

Cholesterol-lowering drugs and aspirin can help with excess levels of Lp(a), but only indirectly. The medicines lower the risk of blood clots and plaque build-up, two activities that Lp(a) encourages within the body.

At high levels, Lp(a) can stick within the body’s arteries to cause narrowing and limited blood supply, along with an increased risk of blood clots, heart attack or stroke. Lp(a) has also been linked to heart failure. Ballantyne said trials have begun to target Lp(a) specifically, but speaking with a doctor is the best method to tackling Lp(a).

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“We are beginning a clinical trial for a therapy that selectively targets Lp(a) but it is in the early phases. The goal is to test a therapy that targets messenger RNA, which in turn prevents Lp(a) from being produced at such high levels. So it will block the protein from being made,” he said.

This illustration depicts a lipoprotein’s structure. Credit: Flickr, CC BY-SA 2.0

Lp(a) was generally not considered a risk for cardiovascular disease, until Ballantyne and a team of researchers published a study about its effects in 2011. Cardiovascular disease was linked to Lp(a), with African Americans demonstrating a larger range of Lp(a) concentrations.

Over a 20-year period, researchers followed up with the participants. Cardiovascular disease events, such as coronary heart disease and stroke, were recorded. Ballantyne said understanding the risk for Lp(a) is important.

“The most important part of knowing your Lp(a) level is understanding your overall risk and finding the right lifestyle modifications or medications to target all the other traditional risk factors,” Ballantyne said. Those risk factors become even more important to monitor when your Lp(a) levels are high.”

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