Lipoprotein(a) (Lp(a)) is becoming increasingly important as an independent risk
factor for cardiovascular disease. Since no effective therapy currently exists
other than lipid apheresis, the recommendation remains to optimally adjust all
other cardiovascular risk factors (CVRF). In a Northwest German population study,
the frequency of elevated Lp(a) levels and all other CVRF was investigated. The
aim was to investigate whether individuals with elevated Lp(a) levels were also
more likely to have other CVRFs. To date, 4602 individuals have been enrolled in
the study, and blood pressure, weight, lipids, diabetes, medications, and
pre-existing conditions were recorded in addition to Lp(a). In addition,
questionnaires assessed physical activity, psychological stress, depression, and
brain dysfunction. All participants received detailed individual recommendation
about their CVRF and its treatment. In the further follow-up of 5 years, it will
be examined how persons with elevated Lp(a) implemented these recommendations in
comparison with participants without elevated Lp(a). The first group Lp(a) 75
nmol/L consisted of 3550 (80.2%), the Lp(a) 75–120 nmol/L group of 341 (7.4%)
and the Lp(a) 120 nmol/L of 538 (11.7%). 81.6% of all participants had one
or more CVRF. Age, sex, and prevalence of hypertension, diabetes, smoking,
obesity, and exercise did not differ among the 3 groups. As expected,
LDL-Cholesterol was significantly elevated in the Lp(a) 120 nmol/L group
despite significantly more frequent use of statins. Significantly more often
hypertensive patients were found in the Lp(a) 120 nmol/L group who were
inadequately controlled by medication and significantly less often persons
without further CVRF. No differences existed in the frequency of psychological
stress, depression, and mild cognitive impairment. CVRF occur with comparable
frequency in individuals with elevated Lp(a) levels. However, individuals with
Lp(a) above 120 nmol/L were more likely to have poorly controlled blood pressure,
elevated LDL-C, and less likely to have no other risk factors. This underlines
that in case of Lp(a) elevation all further CVRF should be intensively adjusted,
especially in case of strongly elevated values 120 nmol/L. However, these
recommendations have not been adequately implemented in clinical care in this
population to date.