A ‘new bad cholesterol’ increases the risk to the heart

Not all so-called bad cholesterol would be equally scary. Now the danger to the arteries is called ‘new bad cholesterol‘, that is to say Lipoproteina (a). Known as Lp (a), it is an important genetic risk factor, neglected for too long, for cardiovascular diseases which represent the leading cause of death in the world, with an estimated 17 million deaths per year. , and which in Italy are responsible for 35.8% of all deaths (32.5% in men and 38.8% in women), exceeding 230 thousand cases annually. Data on the rise, according to the document ‘Prevention 2021‘produced by the Italian Society for Cardiovascular Prevention (Siprec), because Italians are increasingly obese, diabetic, hypertensive and suffering from dyslipidemia.

Discovered more than 50 years ago – recalls an article published by Aleati per la Salute (www.alleatiperlasalute.it), the portal dedicated to medical-scientific information created by Novartis – structurally similar to Low Density Lipoproteins (Ldl, the bad cholesterol ‘ traditional ‘) and synthesized by the liver, is a low-density lipoprotein (Ldl, in fact) associated with an apolipoprotein (a), and for this reason responsible for the transport of cholesterol in the blood.

Like the Ldl, Lp (a), if it has high levels (> 30 mg / dL), helps to increase a person’s overall risk of developing atherosclerotic diseases such as coronary artery disease and stroke. It is no coincidence that he is in the spotlight of the European Atherosclerosis Society (Eas). Lp (a) in fact promotes the accumulation of Ldl on the blood vessel wall, thus favoring the formation of atherosclerotic plaques. Plaques can lead to narrowing of blood vessels and consequent blockage of blood flow, increasing the likelihood of many problems, including heart attack and stroke. Not only. Studies have shown that high Lp (a) levels are associated with a high risk of coronary heart disease and aortic valve stenosis; moreover, people with familial hypercholesterolemia (Fh) have increased plasma levels of Lp (a) compared to those who do not suffer from familial hypercholesterolemia. Conversely, however, low genetically determined levels of Lp (a) [<30 mg/L - (<75 nmol/L)] they are associated with reduced cardiovascular risk.

However, Lp (a) does not respond to standard Ldl lowering therapy, such as a varied and healthy diet, exercise, or statin intake. There are currently no drugs approved to specifically reduce plasma Lp (a) levels, but emerging evidence is rekindling interest in the lipoprotein particle.

Knowing for each individual the future risk of heart attack, and more generally of cardiovascular diseases linked to atherosclerosis, appears fundamental in terms of personalized prevention. For this reason, as the guidelines of the European Society of Cardiology (Esc) and EAS have been recommending for some years, the measurement of Lp (a) is indicated only in patients at high risk for the development of cardiovascular diseases, or with a medical history positive family member for the juvenile onset of cardiovascular diseases. It is essential to undergo the Lp (a) test even after a heart attack or stroke, if you have hypercholesterolemia or have slightly increased levels of Ldl cholesterol. The measurement of Lp (a) takes place through a very simple blood sampling. In general the exam does not require any preparation, however you may be required to take the test after a 12 hour fast.

The complete article is available at: https://www.alleatiperlasalute.it/open-innovation/malattie-cardiovascolari-con-elevati-livelli-di-lipoproteina-il-rischio-aumenta.


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