Health/Sci-TechLifestyleVOLUME 19 ISSUE # 24

Cholesterol experts say everyone needs a little-known blood test

Getting a standard cholesterol screening may soon involve one more blood test that has been around for decades but is rarely used. Evidence continues to mount showing that the additional analysis can flag otherwise unknown risks of dangerous heart problems resulting from plaque buildup in arteries.

The test looks for a particle called lipoprotein(a), and it’s widely available for less than $100. Often referred to as Lp(a), an estimated 1 in 5 people have dangerously high levels of it, usually due to a genetic predisposition. “It is not uncommon for someone to have elevations in Lp(a) despite a normal total or LDL cholesterol reading,” said Nathan D. Wong, PhD, lead author of a new study on Lp(a) in the Journal of the American College of Cardiology.

The latest study from Wong and colleagues is the largest and most ethnically diverse examination to date of Lp(a) in the U.S. and showed that people with very high levels may have up to twice the risk of serious heart problems. Also this month, for the first time a professional medical group in the U.S. has called for every adult to have their Lp(a) levels checked at least once in their lifetime.

“Up to now, Lp(a) has been something mainly discussed among specialists but hasn’t filtered out much to non-specialists and primary care providers. But that is likely to change,” said Gregory G. Schwartz, MD, PhD, chief of the cardiology section at Rocky Mountain Regional VA Medical Center and professor of medicine at the University of Colorado in Aurora, CO. Schwartz said it’s his profession’s responsibility to help educate the wider health care community and general public about Lp(a).

“I don’t think we’re quite at the finish line of that, but we’re getting closer and we’re learning more about this particle that was discovered and first identified in 1963,” he said.

Potentially groundbreaking treatments for high Lp(a) may be just a year or two away. In the meantime, experts are urging their colleagues to help patients learn if they need to address a heightened risk and, since high levels run in families, it’s important for those with high levels to alert their children and relatives who may also be at risk. The evidence is so strong that people don’t need to wait for their doctor to suggest the testing, said P. Barton Duell, MD, a professor of medicine and Lp(a) expert at Oregon Health & Science University.

“They should insist on having their Lp(a) level measured,” said Duell, who sits on the board of directors of the National Lipid Association, which this month recommended that everyone get tested.

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