| When LDL cholesterol combines with a substance | | | | these measurements not only provide guidance for |
| known as Apoliprotein (a), the result is a compound | | | | therapeutic treatment, but also provide valuable insight |
| known as Lp(a), or "ugly" cholesterol. Lp(a) is called | | | | into the success of therapy and the need for adjusting |
| ugly cholesterol because evidence from some | | | | treatment approaches on an ongoing basis." |
| research studies shows that in high levels, it can | | | | Approximately 50 percent of people who have heart |
| increase a person's risk of heart attack or stroke, | | | | attacks do not have elevated cholesterol levels. These |
| even if cholesterol levels are otherwise "desirable." | | | | individuals, however, typically have higher levels of |
| Lp(a) is measured through a blood sample and can be | | | | CRP, Lp(a), Apo S, or homocysteine. As researchers |
| tested as part of a lipoprotein panel. | | | | continue to learn about the exact mechanisms of |
| Genetics determines your levels of Lp(a) and even the | | | | heart disease, more tests are developed to identify |
| size of the Lp(a) molecule itself. Lifestyle changes do | | | | and measure these other risk factors and markers. |
| not alter levels of Lp(a); instead, levels for most people | | | | Treatment for elevated Lp(a) includes niacin therapy. |
| tend to remain consistent over a lifetime except for | | | | Some experts believe that antioxidant therapy is also |
| women, who will experience a slight rise in levels with | | | | useful. People with high levels of Lp(a) benefit by |
| menopause. Some physicians request testing of Lp(a) | | | | concentrating their efforts OR lowering LDL levels |
| for patients who have a strong family history of | | | | since at lower levels, it is harder for LDL particles to |
| premature heart disease or hypercholesterolemia. It | | | | attach to plaque buildup. Lowering LDL levels ultimately |
| can be a valuable test, particularly when other types of | | | | lowers the level of risk. |
| cholesterol are at healthy levels, yet concern exists | | | | According to a study published in the New England |
| that heart disease is developing. Physicians will typically | | | | Journal of Medicine in November 2003, researchers |
| order this test if a patient has had a heart attack or | | | | found that elevated levels of Lp(a) among healthy men |
| stroke, yet cholesterol levels fall within a "healthy" | | | | age sixty-five years and older are predictive of the |
| category. | | | | risk of stroke and death. Study participants with the |
| Berkeley Heart Lab, Inc., based in Burlingame, California, | | | | highest levels of Lp(a) were more likely to experience |
| offers a number of advanced lipid tests-including a test | | | | a stroke and were 76 percent more likely to die than |
| for levels of Lp(a)-that provide quantitative | | | | men with the lowest levels. These researchers |
| determinations of lipoprotein subclasses. According to | | | | support the use of Lp(a) testing as a screening tool to |
| Jeffrey Aroy of Berkeley HeartLab, Inc., "the value of | | | | measure the risk of stroke and heart disease in older |
| the quantitative measurements is that they go beyond | | | | men. |
| simply noting whether levels are 'good' or 'bad.' Instead, | | | | |