From the Guidelines
Reducing lipoprotein(a) [Lp(a)] levels can be achieved most effectively with niacin (vitamin B3) at doses of 1-3 grams daily, which can lower Lp(a) by 30-35%. According to the study published in the European Heart Journal 1, niacin is the only compound that consistently reduces Lp(a) by interfering with apo(a) transcription. Other medications such as statins, fibrates, and drugs interfering with cholesterol absorption have inconsistent effects on Lp(a) levels.
Some key points to consider when reducing Lp(a) levels include:
- Niacin is currently the most recommended drug for Lp(a) reduction, with a reduction of 30-35% 1
- Other medications such as fibrates and statins may have inconsistent effects on Lp(a) levels 1
- Lifestyle modifications such as maintaining a healthy weight, exercising regularly, avoiding smoking, limiting alcohol, and following a heart-healthy diet can help manage overall cardiovascular risk
- Regular monitoring of Lp(a) levels is important for those with elevated values, with testing recommended every 1-2 years to assess treatment effectiveness
It's also important to note that Lp(a) levels can be affected by various factors, including hormones, thyroid function, and kidney disease, as reported in the study published in the European Heart Journal 1. Therefore, it's essential to consider these factors when developing a treatment plan to reduce Lp(a) levels. Additionally, emerging treatments such as antisense oligonucleotides may offer new options for reducing Lp(a) levels in the future.
From the Research
Decreasing Lipoprotein(a) Levels
To decrease lipoprotein(a) [Lp(a)] levels, several strategies can be considered:
- Dietary changes: Replacing saturated fat with carbohydrate, monounsaturated fat (MUFA), or polyunsaturated fat (PUFA) may have varying effects on Lp(a) levels 2.
- Weight loss: Relevant body weight loss has been associated with significantly lower plasma Lp(a) levels 3.
- Dietary supplements: Coenzyme Q10, L-Carnitine, and flaxseed may exert a mild but significant lowering effect on plasma Lp(a) 3.
- Physical activity: Intense physical exercise seems to be associated with significantly lower plasma Lp(a) levels 3.
- Avoiding certain foods: Foods rich in trans-unsaturated fatty acids are associated with increased Lp(a) levels 3.
- Pharmacological agents: PCSK9 inhibitors and lipoprotein apheresis are currently available therapeutic approaches that lower Lp(a) and reduce cardiovascular risk 4.
- Emerging strategies: Antisense oligonucleotides and small interfering RNA agents targeting apolipoprotein(a) have the potential to reduce circulating Lp(a) concentrations by more than 70% 4.