Significant global cardiovascular risk linked to high lipoprotein(a) levels

Review in The Lancet finds that one in five globally are at risk of contracting cardiovascular diseases, because they carry a genetic risk of high levels of a specific lipoprotein, which can be tested for and possibly treated.

20 % of the world population carries a genetic risk factor for cardiovascular diseases such as heart attacks, strokes, and aortic valve stenosis: Increased levels of a lipid particle called lipoprotein(a). It is the most common genetic cause of cardiovascular diseases.

"Lipoprotein(a) is the direct cause of cardiovascular diseases much like cigarettes cause lung cancer. Yet most people that carry an increased amount of lipoprotein(a) are unaware. With new medication under way that lowers the amount of the lipid particle significantly, it is high time we identify individuals who would benefit from it," says first author Professor Børge Nordestgaard, Clinical Professor at University of Copenhagen and Chief Physician at Copenhagen University Hospital - Herlev-Gentofte Hospital, who wrote a comprehensive ABC on lipoprotein(a) in cardiovascular disease, just published in The Lancet.

The technology used for testing for lipoprotein(a) is readily available and easy to use, so while the clinical trials are under way, it makes sense to expand testing globally, says Børge Nordestgaard:

"By expanding testing, we can figure out who carries it and would benefit from lipoprotein(a)-lowering medication. And until the medication becomes available, we can use this knowledge to take better care of individuals with high concentrations of lipoprotein(a) in their blood. The main factors here are making sure to exercise, eating healthy, avoiding smoking and being overweight, and treating high cholesterol levels."

Five drugs are currently in development that can lower the amount of lipoprotein(a) by 65 to 98 %, three of which are in phase 3 clinical trials. Some of the new medication under development is so-called gene silencing therapy.

The medication is injected and then absorbed by the liver cells, inhibiting the production of the lipoprotein(a) and significantly reducing the amount of the lipid particles in the blood and presumably the risk of contracting cardiovascular diseases."

Professor Børge Nordestgaard, Clinical Professor at University of Copenhagen and Chief Physician at Copenhagen University Hospital - Herlev-Gentofte Hospital

The first results showing that a reduction of lipoprotein(a) will reduce cardiovascular diseases are expected to be published in 2026.