Lp(a): A Toolkit for Health Care Professionals

6 20 % 30 % to of the global population 6 Elevated levels prevalent in How High Is Too High? How Common Is It? Lp(a) increases ASCVD risk, especially at higher levels. Black people have the highest Lp(a) levels American Indians have the lowest. 11 What Causes High Lp(a) Levels? The major cause of high Lp(a) levels is genetics. Additional factors that can affect Lp(a) levels include • age • sex • ethnicity • lifestyle • comorbid conditions, such as familial hypercholesterolemia, diabetes or kidney disease. Lp(a) concentration levels may vary by population-specific percentiles. This is because the distribution of Lp(a) levels differs among ethnic groups. 6 Meta-analyses have shown increased risk of coronary heart disease and myocardial infarction with Lp(a) levels above 30 mg/ dL and increased risk of ischemic stroke with levels above 50 mg/dL. According to AHA/ACC cholesterol guidelines, Lp(a) ≥ 50mg/dL constitutes a risk-enhancing factor. Relative indication for its measurement is family history of premature ASCVD. 6