Lipoprotein(a) is a heart disease risk factor, but only at very high levels

Reported by Susan Aldridge, PhD, medical journalist

Women with very high levels of lipoprotein(a) are at increased risk of heart disease.
Lipoprotein(a) is a type of fat-carrying protein found in blood. It is not the same as low-density lipoprotein (LDL, or 'bad') cholesterol. There has been some debate over whether lipoprotein(a) levels are a good indicator of heart disease risk. To clarify the matter, researchers at Brigham and Women's Hospital, Boston, carried out a study of nearly 28,000 women in the Women's Health Study. The participants were followed up for ten years, during which time there were 899 cases of heart disease.

Those with the highest levels of lipoprotein(a) had 1.47 times the risk of heart disease compared to those with the lowest levels. The relationship was especially marked among those with high LDL levels and was independent of other risk factors. But the researchers say that there was no obvious risk gradient among the majority, who had lower lipoprotein(a) levels. They do not believe, therefore, that routine screening for lipoprotein(a) is justified as a way of preventing or detecting heart disease. Measurement of lipoprotein(a) may, however, have a role for those who may be at risk, maybe because they have had a premature heart attack and have no other obvious risk factors.

Source
Journal of the American Medical Association 20th September 2006 Volume 296 pages 1363-1370

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