Have you ever wondered why some people suffer heart attacks despite seemingly perfect health? Meet Sandra Revill Tremulis, a 39-year-old fitness instructor and marathon runner who found herself in that very predicament. Her case not only highlights an often overlooked cardiovascular risk factor but also raises crucial questions about why lipoprotein(a) remains under the radar in preventive health discussions.

What is Lipoprotein(a), and Why Should We Care?

Lipoproteins are the body’s cholesterol transporters, and lipoprotein(a), or Lp(a)—pronounced “L-P-little-a”—is one particular type. Unlike the more familiar LDL cholesterol, which can be managed with lifestyle changes, Lp(a) is dictated entirely by genetics. This means you’re born with your Lp(a) levels, and they remain constant throughout your life.

Sandra’s story underscores the silent threat posed by high Lp(a). Despite her active lifestyle, she had a 95% blockage in a coronary artery due to her elevated Lp(a) levels. It’s an issue that impacts one in five globally, yet remains largely unrecognized. Why is that?

Why Isn’t Lp(a) Testing Common Practice?

Dr. Michael Shapiro, a leading authority in cardiovascular medicine, offers a straightforward explanation: Until recently, there haven’t been treatments available to address high Lp(a), leading to a lack of attention from the medical community. In contrast, LDL cholesterol is well-known because lifestyle changes and medications can effectively lower its levels, reducing cardiovascular risk.

However, that’s starting to change. With several Lp(a)-lowering drugs in the final stages of clinical trials, the landscape of cardiovascular risk management may soon shift dramatically. While it’s clear that high Lp(a) increases cardiovascular risk, the real question is whether lowering Lp(a) will translate to fewer heart attacks and strokes.

So, Should We All Get Tested for Lp(a)?

The push for routine Lp(a) testing is gaining momentum. The National Lipid Association, alongside European and Canadian cardiovascular societies, recommends testing Lp(a) levels at least once for cardiovascular risk evaluation. This is crucial for individuals with risk factors such as a family history of heart disease, early-onset cardiovascular conditions, or specific ethnic backgrounds known to have higher Lp(a) levels.

But why test if there’s no direct treatment yet? Knowing your Lp(a) status can guide more aggressive management of other modifiable risk factors, like LDL cholesterol and blood pressure. People with high Lp(a) should be particularly vigilant about maintaining a heart-healthy lifestyle.

Why Does Awareness Matter?

Imagine being informed at 20 that your Lp(a) levels are dangerously high. This knowledge could motivate significant lifestyle changes—exercising more, adopting a healthier diet, and quitting smoking—all of which can offset cardiovascular risks. Dr. On Chen, an expert in lipid management, emphasizes that while lifestyle won’t change Lp(a) levels, it markedly reduces overall risk.

Moreover, as medical science advances, understanding and tracking Lp(a) could become standard practice in cardiovascular health, much like cholesterol and blood pressure monitoring today.

The Future of Lp(a) in Preventive Medicine

The case for Lp(a) awareness and testing is compelling. As potential treatments emerge, understanding and addressing this hidden risk can transform preventive cardiovascular care. Sandra’s experience is a powerful reminder of the importance of broadening our scope in health screenings, ensuring that potentially life-saving information doesn’t remain hidden in plain sight.

In a world where one in five is at risk, it begs the question: Can we afford to overlook Lp(a) any longer? As the conversation around Lp(a) grows, so too does the potential to reduce the global burden of cardiovascular disease.

Understanding our Lp(a) levels isn’t just about numbers; it’s about empowering individuals to take control of their cardiovascular health before it’s too late.