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Simple blood test reveals dangerous disorder

Top-notch cardiologist Dr. Steven Nissen, recognized as one of Time Magazine's World's Most Influential People, has a suggestion that may help add years to your life. A seldom-used simple blood test, which reveals genetic destiny, can reveal

whether an individual is at high risk or not for cardiovascular disease.

To demonstrate how under-used this test is, "Only one percent out of 1.4 billion people in the world who have this disorder know they have it," said Nissen.

"Most doctors don't even test for [this]," he said. "It's one of those things that most people don't know about." And the test is easily accessible and simple. This blood test can determine a person's Lipoprotein(a) levels and inform doctors and patients if there is a Lipoprotein(a) abnormality.

"If you have [the abnormality], and 20% of the global population has it, you're at substantially increased risk for cardiovascular disease," said Nissen. "There are 64 million people in the U.S. that have this lipid abnormality."

The blood levels tested provide evidence of just what percentage a person's risk factor is. "Depending on how high [a person's] blood levels are, they can be at 50%, even 100% greater risk of developing coronary disease, narrowing of the aortic valve, and some other disorders. It's a very interesting disorder," Nissen explained.

Nissen provided clarity as to why this is such an under-represented but common health condition and why there is a lack of action in ordering the blood test.

"It turns out that the reason nobody seems to know very much about it is because it was never treatable in the past," he said. "It was one of the few heart risk factors that there was no treatment for."

In other words, it was simply not brought to the table because there was no remedy and even more so, lifestyle factors in our control hadn't been recognized to make a difference.

When Dr. Nissen said, "You could eat the best diet in the world and if you have high Lp(a), your blood levels don't change," the gravity of this disorder became apparent.

That is because this disorder is genetic. "Lp(a) is a pure genetic marker. It is fundamentally a genetic problem," he stated in his presentation "Lipoprotein(a) in Coronary Disease: An Emerging Novel Target" (Steven E. Nissen), Houston Methodist DeBakey CV Education, Feb. 14, 2019.

Lp(a) does not discriminate. Lp(a) is a global health problem.

"It doesn't matter if you're male, female, young, old, have a high BMI (Body Mass Index, measure of fat in body), low BMI, low HDL, LDL, this risk factor is pretty much the same regardless of the rest of your phenotype. It's just added on to your intrinsic risk of other things," noted Nissen.

But things are changing. The conversation about Lp(a) is starting; the awareness is starting. Therapies are being developed. Doors are opening. Research and development have led to light at the end of the tunnel.

"The way you develop these therapies is a unique area of medicine," Nissen said. "It is one of the most explosive areas of medicine and it is called gene silencing."

"Your DNA codes to produce messenger RNA, which then tells the cells to make proteins," he continued. "And what we do with this therapy is we give a little snippet of DNA that is complementary to the messenger RNA, and it binds up the

messenger RNA and prevents these proteins from getting formed. So if there is a protein that is harming people, we can block its formation and it's called gene silencing."

"It's revolutionary; it's just absolutely revolutionary," Nissen said.

Nissen said that Swiss pharmaceutical company Novartis is developing a drug named Pelacarsen "that [a patient] can take by injection once a month and it turns off the gene that's making this abnormality that's causing people to be so sick."

He said that a study of about 8,000 people is being conducted "where half of them get a placebo and half get the real thing and we are going to find out if we can prevent people who have an elevated Lp(a) from having recurrent heart attack, stroke and death."

Novartis' press release on Lp(a) therapy explained, "Lp(a) is a lipoprotein that travels through the blood. Elevated levels of Lp(a) collect in the arteries, gradually narrowing the arteries and limiting blood supply to the heart, brain, kidneys and legs."*

Dr. Nissen is not only regarded as a top cardiology expert, but he is recognized as a staunch patient advocate. He said he hopes people take getting this test seriously, and advocates that patients talk with their physicians about it.

If your physician isn't familiar with the test, or doesn't understand the valuable information it can provide you, "It's never wrong to ask for a second opinion," said Nissen.

"There's no one that's going to be a better advocate for you than you," he said.

Dr. Steven Nissen is Chief Academic Officer of the Heart, Vascular, and Thoracic Institute at the Cleveland Clinic. He formerly served as President of the American College of Cardiology. He is a pioneer in his field.


Shelby Ramsey is the author of the blog,, which also features interviews with patients and medical experts.


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