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Understanding LPA and Your Heart Health

Heart health affects every part of your life because the heart pumps oxygen and nutrients to tissues and organs. One factor that influences cardiovascular risk is lipoprotein(a), commonly written Lp(a). Lp(a) is a particle similar to LDL cholesterol that can promote plaque formation in arteries. Higher Lp(a) levels are an independent risk factor for coronary artery disease, heart attacks, and stroke.

The LPA gene helps determine how much Lp(a) your liver makes. A common genetic variant near this gene, rs3798220, is associated with large differences in Lp(a) levels. This page explains what different genotypes at rs3798220 can mean for your Lp(a) levels and heart risk, and provides practical steps you can discuss with your healthcare provider to manage cardiovascular risk.

How to use this information

  • This is educational information about genetic predisposition only. PlexusDx does not provide medical advice.
  • Always review genetic results with your healthcare provider who can interpret them in the context of your medical history, family history, and other test results.
  • Genetics is one piece of the puzzle. Lifestyle, environment, and other health conditions strongly affect heart disease risk.

Genetic Interpretations

Two effect alleles (CC) — higher risk

If your genotype is CC at rs3798220, you carry two copies of the effect allele. This genotype is associated with very high Lp(a) levels, on the order of approximately 15 times higher than typical. People with this genetic pattern have a substantially increased risk of coronary artery disease and may have about double the risk of major cardiovascular events such as heart attack or stroke compared to those without the variant.

Potential clinical considerations to discuss with your healthcare provider:

  • Measure a fasting lipid panel and a direct Lp(a) level to quantify risk.
  • Consider more frequent cardiovascular risk assessment and monitoring.
  • Discuss the potential role of low-dose aspirin for prevention in the context of overall bleeding risk and other medications.
  • Evaluate other risk factors such as blood pressure, diabetes, smoking, and family history of early heart disease.
  • Referral to a cardiologist or lipid specialist may be appropriate for personalized risk reduction and treatment options.
One effect allele (CT) — elevated risk

If your genotype is CT at rs3798220, you carry one copy of the effect allele. This variation is associated with substantially higher Lp(a) levels, approximately 8 times higher than typical. Elevated Lp(a) increases the chance of developing plaque in arteries and raises the risk of heart attacks and strokes.

Potential clinical considerations to discuss with your healthcare provider:

  • Request a measurement of Lp(a) in addition to a standard lipid panel to get a complete picture.
  • Talk about cardiovascular risk reduction strategies tailored to your overall risk profile.
  • Low-dose aspirin may be suggested in some cases, but only after weighing benefits and risks with your clinician.
  • Reinforce control of modifiable risk factors: blood pressure, blood sugar, weight, smoking cessation, and physical activity.
Zero effect alleles (TT) — typical risk

If your genotype is TT at rs3798220, you carry two copies of the non-effect allele. This pattern is associated with average Lp(a) production. Your genetic result at this single variant does not suggest a predisposition to markedly elevated Lp(a) from this locus.

Potential clinical considerations:

  • Routine cardiovascular risk assessment remains important: check a lipid panel, blood pressure, and other standard tests as recommended by your provider.
  • If you have a family history of premature heart disease or other risk factors, your provider may still measure Lp(a) to ensure levels are within a healthy range.
  • Maintain heart healthy lifestyle habits described below.

Diet and Nutrition Recommendations

Regardless of genotype, dietary choices have a major effect on cardiovascular health. Consider the following heart-centered nutrition strategies and discuss personalization with your clinician or a registered dietitian:

  • Emphasize vegetables, fruits, whole grains, legumes, nuts, and seeds.
  • Choose lean proteins such as fish, poultry, and plant-based proteins. Include oily fish rich in omega-3 fatty acids at least twice per week or discuss omega-3 supplements with your clinician.
  • Limit saturated and trans fats by reducing red and processed meats, full-fat dairy, and deep-fried foods. Use healthy fats such as olive oil and avocados.
  • Reduce added sugars and refined carbohydrates which can worsen lipid profiles and body weight.
  • Keep sodium in check by limiting processed and restaurant foods to help control blood pressure.

Supplements and Medications to Discuss

Supplements and medications may influence Lp(a) or overall cardiovascular risk. Only use them under clinical supervision.

  • Niacin can lower Lp(a) in some individuals but may cause side effects. Discuss risks and benefits with your provider.
  • L-carnitine and omega-3 fatty acids have been studied for heart health. Talk to your clinician before starting these supplements.
  • Statins lower LDL cholesterol but have limited effect on Lp(a). They remain important when LDL is elevated.
  • For very high Lp(a) or high overall risk, referral to a specialist may lead to consideration of advanced therapies such as PCSK9 inhibitors or novel Lp(a)–lowering agents under clinical guidance.
  • Low-dose aspirin may be considered for some at elevated risk but should only be started after assessing bleeding risk and overall benefit with your clinician.

Lifestyle Strategies

  • Exercise regularly: aim for at least 150 minutes per week of moderate intensity activity or 75 minutes of vigorous activity, plus strength training twice weekly.
  • Maintain a healthy weight. Modest weight loss can improve many cardiovascular risk factors.
  • Quit smoking and avoid secondhand smoke. Smoking markedly increases heart disease risk.
  • Manage stress through sleep, mindfulness, counseling, or other tools that work for you.
  • Keep routine medical checkups and follow screening recommendations for blood pressure, diabetes, and lipids.

Recommended Tests and Follow Up

  • Measure Lp(a) once to establish a baseline, especially if you have CT or CC genotypes or a family history of early heart disease.
  • Obtain a fasting lipid panel to evaluate LDL, HDL, total cholesterol, and triglycerides.
  • Consider C-reactive protein or other markers if your clinician thinks inflammatory risk assessment is useful.
  • Discuss referral to a lipid clinic or cardiology if Lp(a) is very high or if you have multiple risk factors.

Final Notes and Important Disclaimer

Genetic information can clarify one part of your heart disease risk, but it does not determine your destiny. Lifestyle, medical management, and regular monitoring play central roles in prevention and treatment.

PlexusDx provides educational information about genetic predispositions only. This content is not medical advice. Always consult a qualified healthcare provider before making changes to medications, supplements, or clinical care based on genetic results.