Increasing Lp(a) Awareness for Better Cardiovascular Health: Dr Mary McGowan

In an interview for Lipoprotein(a) (Lp[a]) Awareness Day, Mary McGowan, MD, FNLA, chief medical officer of the Family Heart Foundation and assistant professor of medicine at the Geisel School of Medicine at Dartmouth College, sheds light on the significance of Lp(a) in cardiovascular health. The Family Heart Foundation established the first Lp(a) Awareness Day on March 24, 2022.

Lp(a) is a lipid protein similar to low-density lipoprotein (LDL) cholesterol but with additional components that mimic clotting factors, making individuals with elevated Lp(a) prone to atherosclerosis, thrombosis, and inflammation. Despite its prevalence in 20% of the US population, awareness and testing for Lp(a) remain low, with only a fraction of those at risk being screened.

"Our research at the Family Heart Foundation has found that only 1% of people who have never had a cardiac event have been tested for Lp(a), and only 2% of people who've already had a cardiac event have been tested,” McGowan said in an exclusive interview with The American Journal of Managed Care^® (AJMC^®). “So that means most people with elevated Lp(a) are completely unaware that they're walking around with this increased risk."

During this interview, McGowan emphasized the importance of testing for Lp(a), especially among high-risk populations such as African American and South Asian patients, who are more likely to have elevated levels. Although specific medications targeting Lp(a) are limited, management strategies focus on reducing overall cardiovascular risk factors, including lifestyle modifications and, in some cases, low-dose aspirin.

Highlighting the EPIC-Norfolk study, McGowan noted that individuals with elevated Lp(a) but few other risk factors have significantly lower cardiovascular risk compared with those with multiple risk factors. Lowering LDL cholesterol is crucial, as evidenced by ongoing studies exploring novel therapies aimed at reducing Lp(a) levels by up to 80% to 95%.

McGowan also underscored the potential positive impact of increased LP(a) awareness on health care outcomes by sharing the story of Jennifer, a Family Heart Foundation ambassador who experienced a heart attack despite lacking traditional risk factors. Jennifer's delayed diagnosis underscores the necessity of proactive testing and awareness.

“We're lucky that everything ended well for Jennifer, but that's not always the case,” McGowan said.

In line with Lp(a) Awareness Day initiatives, the Family Heart Foundation is offering 500 free at-home tests for LDL and Lp(a), encouraging individuals to take charge of their cardiovascular health. These tests aim to empower individuals to understand their risk and seek appropriate management, ultimately contributing to better cardiovascular outcomes.