Explanation: A risk factor worse than cholesterol in about 10 percent of the population

From Finns one in ten carries a molecule in their blood that increases the risk of cardiovascular diseases. It is not the so-called bad cholesterol, but a completely independent risk factor lipoprotein (a) eli Lp(a).

The lipoprotein (a) particle also contains cholesterol.

But the current cholesterol drugs and changing the diet to a healthier one do not work for that.

Lp(a) is a lipoprotein similar to LDL cholesterol. It is known to affect the narrowing of arteries due to the cholesterol it carries. Narrowings, on the other hand, can lead to myocardial infarction or cerebral infarction.

The presence of lipoprotein (a) in Finns was confirmed by a recent study population surveywhich was made by the Institute of Health and Welfare (THL).

“We feel that it could be good to study the prevalence of lipoprotein (a) with a large data set. In Europe, it is more common, as up to 20 percent of the population has an elevated concentration,” says THL’s project leader, docent Annamarie Lundqvist.

The investigation is justified by the fact that Lp(a) is even more dangerous than the LDL particle, estimates for example of Harvard Medical School article last year.

Likewise, the first author of the recent study, a specialist doctor, has also described it as “meaner” than bad cholesterol Alpo Vuorio.

The study was based on blood samples from nearly 5,500 Finnish adults of working age. The exact result was that the concentration of lipoprotein (a) in the blood is elevated in approximately 11 percent of men and 10 percent of women.

At the same time, other risk factors for arterial disease were also mapped. The concentration of lipoprotein (a) was slightly higher in those who also had elevated LDL cholesterol and triglycerides.

Still, it can be said that lipoprotein (a) is an independent risk factor. Its high concentration alone significantly increases the risk of heart attacks, especially in those who already have risk factors for arterial disease.

Inconvenient what makes my lipoprotein (a) is that it’s elevated just because of heredity. And its concentration cannot be lowered directly with drugs or lifestyle.

According to Lundqvist, it is still good to identify people with elevated Lp(a). However, it may not be worth measuring for everyone.

“However, there is no evidence that it is a very common risk factor. It increases the risk by about two or three times, but it is not a ticking time bomb. It is worth measuring if there is a family history of arterial disease at an early age,” says Lundqvist.

“On the other hand, one measurement is enough because its value does not change significantly during a lifetime.”

Although lipoprotein (a) transports cholesterol, so commonly used statins do not work for it.

“The statin doesn’t bite into the lipoprotein (a) particle because of its structure,” says Vuorio.

Medicines against Lp(a) are still being developed. Their goal is, for example, to silence the gene that starts the production of Lp(a) in the liver.

“The important thing now is to treat the risk factors that can be treated,” says Lundqvist. Therefore, one treatment is to lower bad cholesterol with medication and changing the diet.

“Lp(a) measurements have only been done a few times, and now it is important to initially focus on people who have significant risk factors for vascular disease. When high Lp(a) concentrations are found, the family members of these people should also be examined,” Vuorio says and continues:

“In the future, hopefully, Lp(a) will be part of the laboratory package that is taken in the initial mapping of vascular disease risk.”

Lp(a) was already defined in the early 1960s. It was discovered by a Norwegian researcher Kåre Berg. Since then, he and his colleagues linked it to the risk of coronary artery disease in the 1970s.

The hereditary Lp(a) gene was discovered at the end of the 1980s and its importance as a risk factor rose in the early 2000s.

The recent population survey was carried out by the Institute of Health and Welfare (THL) and Novartis Finland Oy together with researchers from the University of Helsinki and the Wihuri Research Institute from THL’s Healthy Finland data.