How can you manage elevated Lipoprotein(a)?

00:03:07
https://www.youtube.com/watch?v=VSl09n-P9mk

Summary

TLDRThe video discusses the approach to managing patients with elevated Lp(a) levels in a clinic setting. The primary focus is on controlling other cardiovascular risk factors to prevent heart attacks or strokes, given the lack of specific treatments for high Lp(a). Key strategies include lowering LDL cholesterol, maintaining a heart-healthy diet, managing blood glucose, monitoring blood pressure, maintaining a healthy weight, and engaging in regular aerobic exercise. Additionally, special attention is given to South Asian patients who have different BMI targets. The importance of avoiding smoking and controlling other conditions like autoimmune diseases, depression, or effects from cardiotoxic cancer therapies is highlighted.

Takeaways

  • 💡 Controlling other cardiovascular risk factors is crucial if you have high Lp(a).
  • 🧘‍♂️ LDL cholesterol should be as low as possible for heart health.
  • 🥦 A diet rich in plants and low in saturated fats is recommended.
  • 🏃‍♀️ Engage in 150 to 300 minutes of aerobic exercise weekly.
  • 📊 Monitor and manage blood glucose, especially for diabetics.
  • ⚖️ Maintain a BMI under 25; South Asians may need lower targets.
  • 🚭 Avoid smoking and vaping to reduce cardiovascular risks.
  • 💊 Control autoimmune diseases and manage depression for better heart health.
  • 🔬 Emerging risk factors like adverse pregnancy outcomes require attention.
  • 🔍 Even with high Lp(a), risk reduction through lifestyle changes is possible.

Timeline

  • 00:00:00 - 00:03:07

    In the clinic, for patients with elevated lipoprotein(a) or Lp(a), the focus is on controlling other cardiovascular risk factors. Although there are no treatments for Lp(a) that prevent heart attacks or strokes per current evidence, it's critical to manage overall cholesterol, keeping LDL levels as low as possible. Patients are advised to follow a heart-healthy diet rich in plants and vegetables and low in saturated fats, manage blood glucose levels, maintain a BMI under 25, and have stricter targets for South Asians due to higher glycemic risk. Blood pressure should be monitored and controlled, with recommendations for regular aerobic exercise of 150 to 300 minutes per week. Smoking and vaping should be avoided. In a multidisciplinary approach, additional risk factors such as autoimmune disease, depression, cardiotoxic cancer therapies, and adverse pregnancy outcomes are monitored. Addressing these factors can significantly lower the risk of heart attack and stroke despite elevated Lp(a).

Mind Map

Video Q&A

  • What is the most crucial step in preventing heart attacks if you have high Lp(a)?

    The most crucial step is controlling other cardiovascular risk factors, especially LDL cholesterol.

  • Are there any treatments specifically for reducing Lp(a)?

    Currently, there are no treatments proven to reduce Lp(a) that prevent heart attacks or strokes.

  • What dietary recommendations are given for cardiovascular health?

    A heart-healthy diet enriched with plants and vegetables, and low in saturated fat is recommended.

  • How much aerobic exercise is recommended per week?

    150 minutes of aerobic exercise per week is recommended, with a goal of up to 300 minutes if possible.

  • Why is managing blood glucose important for cardiovascular health?

    Managing blood glucose, especially in diabetics, is important to reduce cardiovascular risk factors.

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  • 00:00:03
    so what can you do
  • 00:00:05
    uh if you have an elevated lpla
  • 00:00:07
    so what we do in our clinic is to
  • 00:00:10
    to make sure that all of their other
  • 00:00:13
    risk factors are under control so if you
  • 00:00:16
    do have a high level uh
  • 00:00:18
    a high lpa the most important
  • 00:00:20
    preventative treatment is to make sure
  • 00:00:22
    all of your other cardiovascular risk
  • 00:00:24
    factors are really well controlled and
  • 00:00:26
    especially your ldl
  • 00:00:29
    we know that there are many new
  • 00:00:30
    treatments in development
  • 00:00:32
    but i want to reiterate that there is
  • 00:00:34
    currently no lpa treatment
  • 00:00:37
    that has been shown to prevent heart
  • 00:00:39
    attacks or strokes
  • 00:00:45
    um so when i spoke about managing all of
  • 00:00:47
    our risk factors for heart attack and
  • 00:00:49
    stroke i think it's
  • 00:00:50
    um extremely important to kind of go
  • 00:00:52
    through what what those are so number
  • 00:00:55
    one managing our cholesterol overall we
  • 00:00:58
    know
  • 00:00:59
    that
  • 00:01:00
    driving that ldl as low as we can is
  • 00:01:02
    extremely important
  • 00:01:04
    we know that making sure that our
  • 00:01:06
    patients follow a heart-healthy diet
  • 00:01:09
    one enriched with plants and vegetables
  • 00:01:12
    based avoiding saturated fat if possible
  • 00:01:16
    we ask that they really manage their
  • 00:01:17
    blood glucose very well and make sure
  • 00:01:19
    they're on proper therapies if they're
  • 00:01:21
    diabetic
  • 00:01:22
    we ask our patients to maintain a
  • 00:01:23
    healthy weight so keeping a bmi less
  • 00:01:26
    than 25 is extremely important and in
  • 00:01:28
    fact in our south asian patients we have
  • 00:01:30
    to lower targets because we know even at
  • 00:01:34
    normal body mass index south asians tend
  • 00:01:36
    to have more glycemic issues
  • 00:01:39
    it's extremely important to make sure
  • 00:01:41
    patients are keeping an eye on their
  • 00:01:42
    blood pressure and if they have high
  • 00:01:44
    blood pressure that it is
  • 00:01:46
    treated to their goal
  • 00:01:48
    we encourage regular exercise uh 150
  • 00:01:51
    minutes of aerobic exercise per week as
  • 00:01:53
    per the american heart association we
  • 00:01:56
    also ask that if they're trying to
  • 00:01:57
    improve your cardiovascular condition to
  • 00:02:00
    try to even increase that up to 300 if
  • 00:02:02
    possible
  • 00:02:04
    we really ask people to refrain from
  • 00:02:06
    smoking or vaping uh which
  • 00:02:09
    is you know becoming an increasingly uh
  • 00:02:11
    large issue amongst our younger
  • 00:02:13
    population
  • 00:02:14
    and actually we are very lucky
  • 00:02:16
    to kind of work in a multi-disciplinary
  • 00:02:19
    fashion to work on emerging risk factors
  • 00:02:21
    so if patients have known autoimmune
  • 00:02:24
    disease making sure that's
  • 00:02:26
    controlled if patients have a known
  • 00:02:29
    history of depression making sure that's
  • 00:02:31
    controlled
  • 00:02:32
    if patients have a known history of
  • 00:02:34
    cancer therapies that are cardiotoxic
  • 00:02:37
    or if they have a history of pregnancy
  • 00:02:41
    adverse pregnancy outcomes making sure
  • 00:02:43
    that really their all their risk factors
  • 00:02:45
    are being watched very carefully
  • 00:02:48
    and so
  • 00:02:49
    even though lpa may be elevated and you
  • 00:02:52
    may not be able to entirely control that
  • 00:02:54
    value there are several other things
  • 00:02:56
    that can really reduce your risk of
  • 00:02:58
    heart attack and stroke
  • 00:03:06
    you
Tags
  • Lp(a)
  • cardiovascular health
  • LDL
  • heart-healthy diet
  • exercise
  • blood pressure
  • cholesterol
  • smoking