A new long-term study reveals that women with extremely elevated levels of lipoprotein(a)—a genetically influenced particle linked to heart disease face a markedly higher risk of developing cardiovascular problems over the course of three decades.
The research, published in JAMA Cardiology, underscores that while moderate increases in lipoprotein(a) may not be alarming, levels above 120 mg/dL or in the top 1% percentile substantially raise the likelihood of major heart events.
- Women with lipoprotein(a) levels above 30 mg/dL or the 75th percentile had about a 74% higher chance of future cardiovascular disease.
- Extremely high levels (>120 mg/dL) were associated with nearly double the risk of coronary heart disease and a significant increase in cardiovascular death.
- The risk of ischemic stroke and death from cardiovascular causes was modestly elevated, primarily in women with the most extreme lipoprotein(a) levels.
Implications for Screening and Prevention:
While current guidelines do not recommend universal screening for lipoprotein(a), the study’s authors suggest that targeted testing could identify women at high risk who might benefit from preventive measures—potentially including future therapies aimed at lowering lipoprotein(a).
The research analyzed data from nearly 28,000 healthy women enrolled in the Women’s Health Study, with a median follow-up of nearly 28 years. Results indicated that genetic factors also played a role, as women carrying specific genetic variants associated with higher lipoprotein(a) levels faced increased cardiovascular risks.
Lead researcher Dr. Ask Nordestgaard emphasized that these findings support considering lipoprotein(a) screening in certain populations, particularly women with very high levels, to guide early preventive strategies.
The study focused on women of European ancestry, and the applicability to other populations remains uncertain. Further research is needed to confirm these findings in men and diverse racial groups.
This study highlights the importance of recognizing lipoprotein(a) as a potent, genetically driven risk factor for cardiovascular disease, opening doors for personalized prevention approaches in the future.
