Managing Lipoproteins - Doctor Q&A

“What should I do if my blood levels of lipoprotein(a) are very high?”

“Is my family history of ischaemic heart disease linked to my own lipid levels?”

Lipoprotein(a), or Lp(a), is an often overlooked but significant genetic risk factor for cardiovascular disease.

Studies have shown that 1 in 5 people worldwide have elevated Lp(a), and locally, 1 in 6 individuals who experienced a heart attack were found to have elevated Lp(a). Despite this, awareness and testing for Lp(a) remain low.

Unlike common cholesterol markers, Lp(a) levels are largely inherited and remain relatively stable throughout life. As Lp(a) is genetically determined, lifestyle changes alone may not be sufficient to manage the risk.

Lp(a) is structurally like “bad cholesterol” (LDL), but with an added protein component that makes it more likely to stick to blood vessel walls, contributing to plaque build-up. This increases the risk of heart attacks, stroke, and other cardiovascular complications.

The good news: early detection of Lipoprotein(a) allows for better risk stratification and targeted management.

As cardiovascular disease remains a leading cause of death in Singapore and globally, individuals with a family history of heart disease, or those who have experienced unexplained cardiovascular events, are encouraged to undergo at least one Lp(a) test in their lifetime.

Individuals can take proactive steps to protect their heart health with the right combination of:

• Monitoring,
• Lifestyle optimisation, and
• Medical interventions

Have questions about Lipoprotein(a), genetic cardiovascular risks and management strategies, don't miss this chance to ask Dr Loh! This Q&A is for a limited time only.

Dr Loh Wann Jia is a Senior Consultant with the Department of Endocrinology at Changi General Hospital (CGH).

She is actively involved in research and teaching, with clinical and research interests in obesity, diabetes mellitus, lipid disorders, and broader metabolic conditions.

To deepen her sub-specialty expertise and foster international collaborations, Dr Loh completed fellowships at hospitals affiliated with Imperial College London in 2017, and at Royal Perth Hospital, Australia, in 2022.

Dr Loh is particularly passionate about advancing the understanding of genetic lipid disorders such as Lipoprotein(a), and works closely with multidisciplinary teams to improve early detection and long-term cardiovascular outcomes for patients.

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