Heart Disease and Lp(a)
How Can We Help Understand and Reduce Heart Disease of Our Rochester and area Patients?
Heart disease currently affects 26.8 million Americans. We think of heart disease as having a “heart attack”, meaning loss of blood supply to an area of the heart muscle which then causes those muscle fibers to die.
Our goal is to prevent heart disease from ever getting to that point. When we look at what really causes “heart disease”, it gets down to inflammation of the blood vessels causing damage to the cells that line our blood vessels, or the “endothelium”.
When we have an area of inflammation in our endothelium, the body tries to repair the damage by laying down cholesterol, thus starting a cholesterol streak or plaque. This plaque continues to grow until part of it shears off and becomes a “clot”, traveling downstream until it lodges in an artery causing blockage and cell death. Thus, we have a heart attack.
Inflammation and Heart Disease
The biggest way to prevent heart disease is to lower inflammation. A reminder of the things that cause inflammation – cortisol being too high or too low, sex hormones being low or for women out of balance, genetics, low vitamin D, environmental toxins and food allergens.
Lp(a) a Genetic Risk Factor
I would like to discuss one of the hidden risk factors for heart disease, Lipoprotein little (a), or Lp(a). For some of us Lp(a) is a hidden genetic risk factor for heart disease, for others it is a protein that carries cholesterol throughout the body that increases during times of stress. However, it acts as a clotting protein, so when our levels are high we are at increased risk for heart attacks and strokes. There is a reason why Lp(a) came on the scene.
Here’s the story:
A very long time ago (as in, millions of years), human beings lost their ability to make vitamin C from sugar molecules. Not just humans, but the great apes, hedgehogs and guinea pigs also lost this ability. Not having the ability to make vitamin C means that we must take it in through our diet. One of the important roles vitamin C has in the body is to maintain the integrity of the endothelium. The ice age brought long stretches of time when fruits and vegetables were not readily available. During these long stressful months, the arteries of our forefathers would start to crack and leak, and people would die of internal hemorrhage.
Along came Lp(a) to the rescue! Lp(a) would act to plug up the cracks so the people who had the Lp(a) genetic mutation survived the long cold winter better. Once fruits and vegetables were available again, vitamin C would take over and the Lp(a) level would go down.
It takes a special cholesterol test called a VAP (vertical auto profile) test to find out if you have high amounts of Lp(a) or not. Most traditional doctors are not using VAP testing, even though it has been around for over 20 years. I find people fall into two categories: those that truly have the genetic risk for Lp(a) with very high levels, and the rest of us whose Lp(a) goes up during stress and back down when our stress is reduced.
For both groups we can lower Lp(a) levels by using buffered vitamin C in doses of 2000-4000mg/day. People with the genetic risk factor may need to add Lysine and L-Proline. An interesting note is that statins (your current typical cholesterol medication) can actually increase Lp(a) in some people.
If you have a family history of heart disease and your cholesterol is slightly elevated, you should obtain a VAP test. It’s just another way you can achieve your optimal health!

