Introduction

In a striking new revelation for cardiovascular health, a subanalysis from the Lp(a)HERITAGE study has uncovered significant disparities in the measurement and prevalence of elevated lipoprotein(a) [Lp(a)] levels among patients diagnosed with atherosclerotic cardiovascular disease (ASCVD). Traditionally linked to higher cardiovascular risk, the need for targeted Lp(a) testing is more pressing than ever, particularly among Black and female patients.

Key Findings

Published in the Journal of Clinical Lipidology, the study indicates that only a mere 14% of US patients with ASCVD had their Lp(a) levels assessed before enrollment. Alarmingly, the data pointed out that elevated levels were notably more common in Black and female participants, underscoring an urgent gap in cardiovascular care. "Despite being a well-established, genetically influenced risk factor for ASCVD, many patients remain unaware of their Lp(a) levels, which could aid in more targeted management," remarked the researchers.

Study Overview

The Lp(a)HERITAGE study, which ran from April 2019 to July 2021, involved over 8,295 participants across 192 locations. Of those, a total of 7,679 US participants were included in this subanalysis, with 552 individuals having their Lp(a) measured before the study and 7,127 during the study. The demographics revealed critical insights: while 80.5% of the participants identified as White, Black participants made up 16.9%, and only 8.0% identified as Hispanic. The mean age was 63.8 years, with a notable lack of older individuals among Black participants, which suggests underrepresentation in typical cardiovascular risk assessments.

Disparities in Testing

The findings highlighted that only 14.3% of White, 11.8% of Black, and 9.1% of Hispanic participants had prior Lp(a) measurements, sparking concerns about equitable access to important diagnostic testing. Intriguingly, female participants showed a slight advantage in Lp(a) testing, with 14.9% measured prior, compared to 13.7% of male participants.

Limitations and Implications

Researchers acknowledged a few limitations, including the descriptive nature of the study design and potential biases due to non-standardized local laboratory testing for Lp(a). Despite these constraints, the results strongly suggest that Lp(a) testing is severely underutilized among ASCVD patients in the U.S., a worrying trend given the strong association between elevated Lp(a) levels and cardiovascular risk.

Conclusion

With no specific pharmacological therapies available yet for lowering Lp(a), the urgency for awareness and testing is paramount. "Even in the absence of drug therapies, understanding Lp(a) levels can lead to better risk stratification and lifestyle modifications that are essential for a heart-healthy future," the researchers emphasized.

Call to Action

As cardiovascular diseases remain a leading cause of death worldwide, this study paves the way for deeper conversations around ethnic disparities in healthcare, the importance of proactive testing, and the critical need for tailored heart disease management strategies. Would you be willing to get tested for Lp(a)? It's a conversation worth having!