Just found out Lpa is extremely high — other risks OK

I am 56 & just found out my LPa is 495!!! I am freaking out. Saw my cardiologist & was basically told “it is what it is” and to keep taking my low statin. I’ve also read statins increase LPa, I have so many questions they couldn’t answer. I’m at a loss for what to do. I’ve been reading about it, watching videos about it, haven’t read about anyone else’s levels as high as mine. I feel helpless & afraid.

@jp1234 I am so sorry you are dealing with this. I had a high CAC score (538) and my Lp(a) is 256 (and I'm currently 48 years old). I often feel scared and anxious about it all, too. See my other posts for more information on the tests I've had and my diagnosis. But for me the toughest piece is the emotional one. I am very stressed and worry frequently about dropping dead of a heart attack. I also have a young child, which makes me even more anxious and worried about leaving her without me.

In terms of the more practical stuff: My cardiologist has been treating me as a high-risk patient in terms of getting my LDL-C below 55, which seems the best thing you can do to lower your risk despite the high Lp(a) number. This is the same LDL-C goal they have for people who have already had a heart attack or other major event. Right now, there is nothing you can do about your Lp(a). But the good news is that medications that lower Lp(a) are coming soon - in the next few years - and one might even become available in 2026. Rapatha lowers it some, but I think it doesn't lower it enough to make a meaningful difference for most people and it's very expensive - so it is only prescribed if you need it to lower your LDL-C (because statins and ezetimibe don't get it low enough, or because you can't tolerate statins). In terms of treatment, I take aspirin (which is only for those under 60), Crestor, Zetia, metoprolol (I have anxiety - so this is a small dose for my racing heart beat and not to treat high BP), and Wegovy.

You should perhaps try to find a different cardiologist who better addresses your questions. I don't love that my doctor often doesn't bring things up until I ask, but at least if I stay informed and then ask questions, he always gives clear and thoughtful answers.

Personally, my main source of comfort these days is thinking about the drugs that will hopefully be available soon - I am just hoping everything is ok until I can start on something that lowers my Lp(a) directly. I think I will be much more relaxed about my diagnosis when I know that I have lowered that number, since it really seems that Lp(a) is the worst form of cholesterol there is and it sucks to not be able to do anything about it. I also try to take solace in the fact that, even though my grandfather died in his early 50s of a heart attack and many of us who are descended from him have been diagnosed with CVD, everyone is still alive and none of them have had a heart attack - and some of them are in their 80s. So it isn't a death sentence. But it can be hard to remember that in the middle of the night!

I hope you can find some peace around the anxiety. For me, I do my best to try to accept CVD for what it is - I see it as a call to make sure I am doing all I can to stay healthy, a reminder to enjoy my life and tell my family every day that I love them, and otherwise it is a set of risk factors that I must live with and accept as a part of my life. I don't like it, but there is only so much I can do about it. All our lives are fragile and we live with risk all the time. This is just one more to add to the pile -- and then to try to ignore the way we do so many others!

@jp1234
Hi, I started this post a while ago and was feeling exactly like you. I am in my late 60's and do all the right things for my health. My Lpa is 380. I only tested because my brother who also has no apparent heart risks other than high cholesterol found though unrelated tests that he had major blockages in all his arteries and now has stents. His Lpa was 430 and they told him to have family members tested. I went to a cardiologist who said the best thing is to get the LDL down below 50 and follow heart-healthy lifestyle. I was constantly worrying that I could have a stroke or heart attack even though I had no symptoms. The important thing is to be aware of any strange symptoms and follow up asap. If there are symptoms they can intervene and do something . Here's the interesting thing--my doctor ordered a stress test just to rule out issues and I thought I did a great job. She called me that night and said I failed it and it looked like the left ventricle was not working correctly and immediately ordered a catheterization (this is the only true test to show any blockages inside the arteries). I had the catheterization and was expecting to wake up with stents but instead they said all my arteries were clear and the stress test was a false positive which can sometimes happen. Bottom line is high Lpa is a risk factor and not a guarantee of having CAD. Meanwhile my LDL is down to 47 using 40 mg of Crestor which is more potent than Lipitor. I still do all the heart healthy things and pay attention to my body. I am also waiting for the new drugs to treat Lpa. The good news is by knowing you have high Lpa you can mitigate otherer risks by doing all the heart-healthy things within your control and watching your LDL. It is the people who do not know they have high Lpa and do not take care of other risk factors that are at more risk in my opinion. Treat this as a blessing since it is a wake-up call to live as healthy as you can and remember high Lpa is one risk factor of several. Hope this helps. Hang in there and keep looking for help and answers for your particular circumstances.

@lynna54
Thank you so much for responding so quickly & for your encouragement. Just had never heard about LPa until recently & happened to ask my cardiologist about it and he ordered the test. My LDL is around 90 & they did say to try & get it to 50. I am thankful to know, but having kept my weight down all my life, and pretty active I just had no worry about cardiovascular issues. I have encouraged my mom & siblings & my daughter to get tested as well. I really appreciate all the information you provided & helping me put it in perspective. Thank you - God bless ❤️

@star123
Thank you for your response & encouragement. My kids are young adults but I still want to be here in life for them & now have a new grandbaby I hope to enjoy for many years to come so I understand your anxiety about having young children & them needing their mommy. I have been treated for palpitations most of my adult life with propanolol to keep them at bay, and all my cardiac tests over the years have been normal. I have read about the aspirin therapy, so I’m glad you mentioned it. I would like to ask my cardiologist ( or find a new one) about that. I know it doesn’t lower it, but makes it less sticky?? I try not to think about it all the time as you said we really don’t have control over the level of LPa in our bodies, but helpful to know there are some factors I can control. Thank you again.