Like many people, I had to insist on LP(a) testing. The test was not covered by insurance but it was inexpensive. Knowing that I do not have elevated LP(a) is valuable information. People need to be informed. The medical community will not do the work for us. Thanks for the article.
I recently went to another cardiologist for the first time and had a good half hour discussion of my risk factors, and so I think things are changing, but my experience is that many doctors tend "dumb down" the situation unless they can tell that a patient has done his homework.
I found out this year that I have a genetic issue after my mom had 2 strokes in the last 6 months, and I found myself a cardiologist. My mom is 75, but her father died at 43 of a stroke, and her older sister died at 80 after a series of strokes. (My mom survives, has had 3 strokes total). I am 53 now, and my cardiologist ordered a Lp(a) test. However, I live in an area where they do many clinical trials, and it turned out that a company (Care Access) was looking for people for a study of Lp(a) - they actually paid for a blood test and will tell you your results or send them to your doctor. Of course, I am happy to participate in a trial if selected. The blood test showed my Lp(a) is high. My cardiologist started me on Crestor and my new LDL is 67, but she said not good enough! and now I am also on Zetia/Ezetimibie. Crossing my fingers a bit and walking more! My CAC score is also above 0. I doubt I will retire one second later than I need to based on this information. I am happy to share a link where anyone interested can sign up for the blood test if it is near you (they do have many locations in more than one state), not sure if that is allowed or not. If so, I can edit this post or respond to you directly.
What about APOe4 gene? Especially, if you have 2. But my recollection is that having an APOe4 gene would just increase LDL, so it may not by itself be an independent risk factor, correct?
Also, as I recall APOe4 is a risk factor for dementia/Alzheimers. But that too may be due to higher cholesterol.
The APOE4 issue is relevant but you are correct that the risk of cardiovascular disease is largely mediated via the lipids which at least makes it visible to an extent.
Thank you Dr. Paddy. Great article and also good to know that testing and knowing can have consequences for Mortgage and other applications.....hasten slowly so. Hadn't previously understood that normal cholesterol reading may still have LP(a).
The insurance question can largely be avoided by focusing on the fundamentals. It does seem unfair however that those who are proactive can be punished.
Brilliant and clearly stated as always. Thanks for this content.
I believe there's a mistype in the unit conversion of cholesterol here:
"When someone starts quoting figures of 8 mmol/l (10 mg/dl) then we are starting to move into FH territory."
Thanks. Yes. Conversion not correct. A common mistake of mine as I usually only deal in mmol. Updated on site.
Like many people, I had to insist on LP(a) testing. The test was not covered by insurance but it was inexpensive. Knowing that I do not have elevated LP(a) is valuable information. People need to be informed. The medical community will not do the work for us. Thanks for the article.
This is a common story but the tide is changing. Slowly.
I recently went to another cardiologist for the first time and had a good half hour discussion of my risk factors, and so I think things are changing, but my experience is that many doctors tend "dumb down" the situation unless they can tell that a patient has done his homework.
I found out this year that I have a genetic issue after my mom had 2 strokes in the last 6 months, and I found myself a cardiologist. My mom is 75, but her father died at 43 of a stroke, and her older sister died at 80 after a series of strokes. (My mom survives, has had 3 strokes total). I am 53 now, and my cardiologist ordered a Lp(a) test. However, I live in an area where they do many clinical trials, and it turned out that a company (Care Access) was looking for people for a study of Lp(a) - they actually paid for a blood test and will tell you your results or send them to your doctor. Of course, I am happy to participate in a trial if selected. The blood test showed my Lp(a) is high. My cardiologist started me on Crestor and my new LDL is 67, but she said not good enough! and now I am also on Zetia/Ezetimibie. Crossing my fingers a bit and walking more! My CAC score is also above 0. I doubt I will retire one second later than I need to based on this information. I am happy to share a link where anyone interested can sign up for the blood test if it is near you (they do have many locations in more than one state), not sure if that is allowed or not. If so, I can edit this post or respond to you directly.
It’s always important to remember that just because you can’t lower Lp(a) {For now} we can still reduce risk by focusing on the fundamentals.
What about APOe4 gene? Especially, if you have 2. But my recollection is that having an APOe4 gene would just increase LDL, so it may not by itself be an independent risk factor, correct?
Also, as I recall APOe4 is a risk factor for dementia/Alzheimers. But that too may be due to higher cholesterol.
The APOE4 issue is relevant but you are correct that the risk of cardiovascular disease is largely mediated via the lipids which at least makes it visible to an extent.
Thank you Dr. Paddy. Great article and also good to know that testing and knowing can have consequences for Mortgage and other applications.....hasten slowly so. Hadn't previously understood that normal cholesterol reading may still have LP(a).
The insurance question can largely be avoided by focusing on the fundamentals. It does seem unfair however that those who are proactive can be punished.