Lipoprotein(a) Elevation (Hyperlipoproteinemia): Treatment

Therapy for hyperlipoproteinemia (here: Lipoprotein (a) elevation) is based on the following pillars:

  • Secondary prevention, that is, reduction of risk factors.
  • Drug therapy
  • Micronutrient therapy (vital substances)
  • Operative therapy
  • Other therapy
    • Lifestyle modification

The treatment modality for hyperlipoproteinemia depends on the level of LDL measured and the risk factors the individual has:

Risk group LDL target value in mmol/l (mg/dl) LDL value at which lifestyle changes should be made LDL level at which drug therapy should be started
10-year risk > 20% < 2,6 (< 100) ≥ 2,6 (≥ 100) ≥ 3.4 (≥ 130)optimal from 2.6-3.3 (100-129)
10-year risk 10-20 < 3,4 (< 130) ≥ 3,4 (≥ 130) ≥ 3,4 (≥ 130)
10-year risk 10% < 3,4 (< 130) ≥ 3,4 (≥ 130) ≥ 4,1 (≥ 160)
0-2 risk factors < 4,1 (< 160) ≥ 4,1 (≥ 160) ≥ 4.9 (≥ 190)optimal from 4.1-4.9 (160-189)

The risk groups are composed as follows

First, the individual risk factors are added together, and if more than two risk factors are present, a specific calculation pattern is used to calculate the various categories of 10-year risk of coronary heart disease – disease of the vessels supplying the heart.

Risk factors include:

  • Alcohol consumption (woman: > 20 g/day; man > 30 g/day).
  • Tobacco consumption
  • Hypertensionhigh blood pressure above 140/90 mmHg or taking antihypertensives (medication for high blood pressure).
  • Low HDL cholesterol – < 1.0 mmol/l (< 40 mg/dl).
  • Diabetes mellitus
  • Family history positive for early coronary heart disease – disease of the vessels supplying the heart – in male first-degree relatives < 55 years/ in female first-degree relatives < 65 years of age.
  • Age – males ≥ 45 years, females ≥ 55 years.
  • Obesity (obesity)
  • Lack of exercise
  • Eating habits
  • Elevated laboratory values of
    • lipoprotein (a)
    • Homocysteine
    • Prothrombotic factors – coagulation
    • Proinflammatory factors – signs of inflammation.
    • Fasting glucose (blood glucose; BG)

Furthermore, the highest possible HDL level is also important for the prevention of serious cardiovascular disease. It should be > 1.0 mmol/l (> 46 mg/dl).

Triglyceride levels should be in the following range:

  • < 1.7 mmol/l (< 150 mg/dl).