Lp(a) Treatment: What Works, What Doesn’t, and How to Take Control

When it comes to heart disease, most people focus on LDL cholesterol—but Lp(a), a genetically driven lipoprotein that acts like LDL but sticks to artery walls and triggers inflammation. Also known as lipoprotein(a), it’s one of the most underrated risk factors for early heart attacks and strokes. Unlike regular cholesterol, Lp(a) levels are mostly set by your genes—you can’t fix them with diet or exercise alone. About 1 in 5 people have high levels, and many don’t know until they have a heart event despite eating clean and working out regularly.

That’s why lipoprotein(a), a particle that’s both cholesterol-carrying and clot-promoting is so dangerous: it slips under the radar. Standard lipid panels don’t always test for it, and even if they do, doctors often don’t know what to do next. There’s no magic pill yet, but new drugs like pelacarsen and olpasiran are in late-stage trials and show real promise in slashing Lp(a) by 80% or more. Until those are widely available, the focus shifts to managing everything else you can control—like blood pressure, smoking, and inflammation.

cardiovascular risk, the combined threat of heart attack, stroke, and vascular disease isn’t just about one number. If your Lp(a) is high, your doctor should also check your LDL, triglycerides, and C-reactive protein. High Lp(a) + high LDL is a double hit. That’s why statins are still often prescribed—not to lower Lp(a), but to reduce the rest of the damage. Some patients benefit from PCSK9 inhibitors like evolocumab, which can lower Lp(a) by 20-30%, a modest but meaningful drop. Niacin used to be used, but studies show it doesn’t improve outcomes and causes too many side effects. And don’t waste time on fish oil or plant sterols—they don’t touch Lp(a).

If you’ve had a heart attack before 55 (men) or 65 (women), or if close relatives did, ask for an Lp(a) test. It’s a simple blood draw. No fasting needed. If your level is over 50 mg/dL, you’re in the high-risk zone. That doesn’t mean you’re doomed—it means you need a smarter plan. Focus on strict blood pressure control, avoid smoking completely, and consider low-dose aspirin if your doctor says it’s right for you. Regular exercise helps your overall heart health, even if it doesn’t change Lp(a). And if you’re on a statin, make sure your LDL is below 70, maybe even 55, to offset the genetic risk.

The science is moving fast. In the next few years, we’ll likely have the first FDA-approved drugs specifically for Lp(a). But right now, your best move is awareness. Know your number. Know your family history. And don’t let a silent genetic risk slip by because no one talked about it. The posts below cover everything from how Lp(a) is measured, to real patient stories, to what new treatments are on the horizon—and how to talk to your doctor about it without getting brushed off.

Lipoprotein(a): Understanding Your Genetic Cholesterol Risk and What You Can Do

Martyn F. Dec. 9 8

Lipoprotein(a) is a genetic cholesterol risk factor that increases heart attack and stroke risk, even when other cholesterol levels are normal. Learn who should be tested, why diet won't help, and what new treatments are coming.

More Detail

The Role of Antioxidants in Preventing Reperfusion Injury

As a blogger, I've recently been diving into the importance of antioxidants in our health, and I discovered their crucial role in preventing reperfusion injury. For those who aren't familiar, reperfusion injury occurs when blood flow is restored to an area after being blocked, leading to inflammation and oxidative damage. Antioxidants come to the rescue by neutralizing harmful free radicals and reducing oxidative stress, which ultimately helps to prevent tissue damage and inflammation. They also support the healing process by promoting cell regeneration and repairing damaged tissues. Overall, antioxidants play a vital role in our body's defense against reperfusion injury, highlighting the importance of maintaining a healthy diet rich in these powerful substances.

Gouty Arthritis and Exercise: Staying Active Without Triggering Flare-Ups

As someone who has experienced gouty arthritis, I understand the importance of staying active without triggering painful flare-ups. One crucial aspect is to choose low-impact exercises like swimming, walking, or yoga, which are gentle on the joints. Always remember to start slow and gradually increase the intensity to avoid overexertion. It's also essential to stay well-hydrated and maintain a healthy diet to keep uric acid levels in check. Lastly, don't forget to listen to your body and rest when needed, as pushing yourself too hard can do more harm than good.

COPD Exacerbations: Common Triggers, Warning Signs, and What to Do in an Emergency

COPD exacerbations are dangerous flare-ups that worsen breathing, often due to infection or pollution. Learn the warning signs, what happens in your lungs, emergency treatments, and how to prevent the next one.