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NEW HOPE FOR LOWERING LP(a)

Lipoprotein (a) or simply Lp(a) levels , are genetically determined.  When elevated they are a risk factor for both coronary disease and aortic stenosis. This is no small problem, because as many as 20% of the population is affected. As an integrative cardiologist, I measure Lp(a) levels in essentially all my patients with abnormal lipids, which include both cholesterol and triglyceride levels. In my patients who have experienced a cardiac event such as a heart attack or stroke, or have received balloon angioplasty/ stent or bypass surgery, this measurement is even more crucial.

Up until now, there have been no effective treatments. Statins may work well in lowering LDL cholesterol, but they do nothing to lower Lp(a). Exercise and diet also play no role. It’s simply genetic and lifestyle measures do nothing.

That is until now! An investigational drug targeting LPA gene expression successfully reduced levels of Lp(a) . This was a modest study comprising 286 patients, but it was double-blinded, and placebo controlled. Lp(a) lowering was dose dependent and observed as early as the first month of therapy. The study was led by investigators at UCSD and Ionis Pharmaceuticals.

The 80% reduction in Lp(a) levels would be expected to have a major impact over currently available therapies . For years I have used niacin in relatively high doses to lower Lp(a) levels. However, I have often noted varying success.

Drugs are no panacea. This drug will be expensive and not without potential side effects. However, the ability to lower Lp(a) levels in a large cohort of patients where lifestyle management is ineffective  will hopefully affect outcomes in a positive way.

You can read the original article from MedPageToday by clicking HERE.

Source Reference: Zheng B, et al "Insomnia symptoms and risk of cardiovascular diseases among 0.5 million adults: A 10-year cohort" Neurology 2019; DOI:10.1212/WNL.0000000000008581.