The review in The Lancet finds that one in five people worldwide are at risk of heart disease because they carry a genetic risk of high levels of a particular lipoprotein, which can be controlled and potentially treated.
20% of the world’s population carries a genetic risk factor for cardiovascular disease such as heart attacks, strokes and aortic valve stenosis: Elevated levels of a lipid particle called lipoprotein(a). It is the most common genetic cause of cardiovascular disease.
“Lipoprotein (a) is the direct cause of cardiovascular disease, like smoking causes lung cancer. However, most people who carry an increased amount of lipoprotein (a) do not know it. It is time to identify people who will benefit from it,” says first author Professor Børge Nordestgaard, Clinical Professor at the University of Copenhagen and Chief Physician at the University Hospital of Copenhagen – Herlev-Gentofte Hospital, who wrote a comprehensive ABC on lipoprotein(s) in cardiovascular disease, just published in The Lancet.
The technology used to monitor lipoprotein(a) is readily available and easy to use, so while clinical trials are ongoing, it makes sense to expand the trials worldwide, says Børge Nordestgaard:
“By expanding testing, we can understand who does and will benefit from lipoprotein(a)-lowering medication. And until the drug becomes available, we can use that knowledge to better care for people with high lipoprotein concentrations (a) In their blood the main factors here are making sure they exercise, eat healthy, avoid smoking and being overweight and treat high cholesterol levels.’
Five drugs are currently being developed that can reduce the amount of lipoprotein (a) by 65 to 98%, three of which are in phase 3 clinical trials. Some of the new drugs being developed are so-called gene silencing therapy.
The drug is injected and then absorbed by the liver cells, inhibiting the production of lipoprotein (a) and significantly reducing the amount of lipid particles in the blood and possibly the risk of cardiovascular disease.”
Professor Børge Nordestgaard, Clinical Professor at the University of Copenhagen and Chief Physician at Copenhagen University Hospital – Herlev-Gentofte Hospital
The first results showing that lowering lipoprotein(a) will reduce cardiovascular disease are expected to be published in 2026.
Source:
Journal Reference:
Nordestgaard, BG & Langsted, A., (2024) Lipoprotein(s) and cardiovascular disease. The Lancet. doi.org/10.1016/S0140-6736(24)01308-4.
