From the Guidelines
Low lipoprotein(a) (Lp(a)) levels are generally considered beneficial and indicate a lower risk of cardiovascular disease. Lp(a) is a type of lipoprotein that combines LDL cholesterol with a protein called apolipoprotein(a) 1. Having naturally low Lp(a) levels is not a cause for concern but rather a favorable finding. Low Lp(a) levels (typically below 30 mg/dL or 75 nmol/L) suggest a reduced risk of:
- Atherosclerosis
- Heart attacks
- Strokes
- Aortic valve stenosis Lp(a) levels are primarily determined by genetics and remain relatively stable throughout life, with limited influence from diet or lifestyle factors 1. There are currently no specific medications targeted at lowering Lp(a) for the general population, though several are in development 1. If you have low Lp(a), no specific action is needed regarding this particular marker, but maintaining overall cardiovascular health through:
- Regular exercise
- Healthy diet
- Not smoking
- Controlling other risk factors remains important. It's worth noting that Lp(a) levels are highly prevalent, genetic risk factor for cardiovascular disease (CVD) and calcific aortic valve disease (CAVD), and elevated levels affect 20–30% of the global population 1.
From the Research
Low Lipoprotein(a) Indications
- Low lipoprotein(a) (Lp(a)) levels are generally considered to be below 50 mg/dL or 125 nmol/L 2, 3.
- Individuals with low Lp(a) levels are at lower risk for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis compared to those with high Lp(a) levels 2, 3, 4.
- The risk associated with low Lp(a) levels is further reduced when low-density lipoprotein cholesterol (LDL-C) levels are also low (<2.5 mmol/L) 5.
Cardiovascular Disease Risk
- Low Lp(a) levels are associated with a lower risk of cardiovascular disease, including coronary artery disease, peripheral arterial disease, and ischemic stroke 4.
- The relationship between Lp(a) and cardiovascular disease risk is independent of LDL-C levels, but the risk associated with high Lp(a) levels may be attenuated at low LDL-C levels 5.
Clinical Implications
- Measuring Lp(a) levels may be useful in identifying individuals at high risk for cardiovascular disease, particularly those with a family history of cardiovascular disease or those who are resistant to statin therapy 6.
- Emerging therapies that target Lp(a) reduction, such as antisense oligonucleotides and small interfering RNA agents, may provide new treatment options for individuals with high Lp(a) levels 2, 3.