You might think being fit protects you from heart disease. After all, you run, lift, eat right, and your cholesterol is “good.” But a recent case report documented in Frontiers of Cardiovascular Medicine proves that looks can be deceiving.
A veteran athlete in his late 40s was the picture of health. No family history of heart disease, low blood pressure, active lifestyle. Even his 10-year QRISK3 heart risk score said he was basically untouchable: just 4.1%.
Yet, something unusual showed up in his bloodwork: high levels of lipoprotein(a), or Lp(a).
What is Lp(a)
Lp(a) is a type of lipoprotein that is similar to LDL cholesterol – the ‘bad’ cholesterol you have probably heard about. The difference, Lp(a) is mostly determined by your genes meaning your lifestyle has little effect on it.
If your Lp(a) levels are high, it can stick to your artery walls and speed up the build-up of plaque that narrows your arteries. In fact, Lp(a) tends to stick to the artery walls more readily than LDL Cholesterol and can raise your risk of heart disease or stroke at a younger age.
The Case Report
The recent case report in Frontiers of Cardiovascular Medicine describes a man in his late 40s with no obvious symptoms, he presented for cardiac screening ahead of participation in several ultra-endurance events including an extreme high altitude mountain summit. He had no family history of cardiovascular disease and maintained excellent cardiovascular fitness.
His blood test results showed elevated Lp(a), total cholesterol and LDL cholesterol with low HDL cholesterol. Other biomarkers including triglycerides and ApoB were normal. His 10-year QRISK3 score was just 4.1% indicating a low 10-year risk of cardiovascular disease. The QRISK3 score is a commonly used calculator for estimating a person’s 10-year risk of having a heart attack or stroke and is based on factors like age, sex, ethnicity, blood pressure and cholesterol. It also incorporates conditions like diabetes and kidney disease.
Despite the patients low QRISK3 score, his significantly elevated Lp(a) levels prompted further investigation. Advanced heart imaging revealed severe coronary artery disease, including 75% narrowing in a major artery. Had he proceeded with the planned high-altitude summit, the combination of extreme exertion, hypoxia and underlying severe coronary disease could have been devastating, with a substantial risk of acute coronary events or sudden cardiac death.
Why You Should Care
Traditional heart health tests like LDL and HDL Cholesterol don’t always tell the complete story. You can feel fit, perform well and still carry a hidden risk for cardiovascular disease.
Lp(a) is inherited largely unaffected by diet and lifestyle. Despite its importance, Lp(a) is not routinely included in standard blood tests meaning many people are unaware of their risk. Recent Randox Health data shows as many as 1 in 6 people have high Lp(a) levels. You can read more here – Meet Lp(a): The Heart Risk Factor You’ve Probably Never Heard Of
Testing is easy, a simple blood test at Randox Health can identify if you have high Lp(a) levels that may be missed during standard GP check-ups.
Even the healthiest people should consider Lp(a) testing. It’s like finding a hidden speed bump on a highway—better to know before you hit it.
Take control of your heart health today
Lp(a) is just one piece of the bigger picture when it comes to cardiovascular risk. Our popular Everyman and Everywoman comprehensive health checks assess key markers including Lp(a), cholesterol, inflammation, blood sugar and more — giving you a complete view of your heart health.
Discover the Everyman | Everywoman tests at Randox Health and book your comprehensive health check today.