Transcript
Announcer:
This is Heart Matters on ReachMD. Today, Dr. Nishant Shah will explain how he manages a case of elevated lipoprotein(a). Dr. Shah is an Associate Professor of Medicine at Duke University School of Medicine in Durham, as well as a Member of the Duke Clinical Research Institute. Let’s hear from him now.
Dr. Shah:
If a patient has an elevated Lp(a), the first thing I like to tell a patient is that this is not their fault. They did not do this to themselves. This is something that was made in their genetics.
And the biggest hurdle of knowing that you have an elevated Lp(a) is getting the test in the first place. The vast majority of people don't even get the test. So the fact that this person already got the test means they're already well ahead of the curve when it comes to prevention of cardiovascular disease. Now that we know we have an elevated level, we know we have a high marker of risk. So now, we can actually start putting them on evidence-based therapies such as therapies to reduce LDL cholesterol, seeing if their blood pressure needs work, seeing if their weight needs work, seeing if their blood glucose needs work, if they're smoking, help them stop smoking—being aggressive with the modifiable risk factors that we know and have been proven to improve cardiovascular outcomes. That's exactly what I say: this is our opportunity to be proactive rather than reactive.
And if they have an elevated level, the next thing I do after modifying their individual risk is I ask them to see if their first-degree relatives can also be tested for Lp(a) to see if the same strategies need to be applied to them. First-degree relatives are parents, siblings, or children. And for children, I typically recommend adult children get screened, as I'm an adult cardiologist. However, a lot of pediatric cardiologists are also having conversations around appropriate lipid screening and doing it early rather than waiting until later. And so that conversation, I believe, will continue to evolve. But especially if you have adult children, I would definitely recommend screening if you have an elevated Lp(a).
Announcer:
That was Dr. Nishant Shah discussing management strategies for patients with elevated lipoprotein(a). To access this and other episodes in our series, visit Heart Matters on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening.