KnowyourLpa

Lp(a) in Women

Extra attention for heart health at every stage of life

Cardiovascular disease is the leading cause of death among women worldwide, even before breast cancer. Yet, the risk is often recognized too late, because symptoms in women tend to present differently than in men. Genetic factors, such as elevated lipoprotein(a) or Lp(a), play a greater role than many women realize. During pregnancy, menopause, and other hormonal transitions, the influence of estrogen, blood pressure, and fat metabolism changes. These shifts can make blood vessels more vulnerable to damage. That’s why measuring Lp(a) early, especially if heart disease runs in the family is so important.

Did you know…

  • About 1 in 5 women have elevated Lp(a) levels.
  • Women with high Lp(a) are up to three times more likely to develop cardiovascular disease after menopause.
  • Heart problems in women tend to occur 10 years later than in men, but once they appear, they are often more severe.


Why Lp(a) affects women differently

Although high Lp(a) levels occur just as frequently in women as in men, the impact on the blood vessels can differ. During the fertile years, the hormone estrogen protects the arterial walls from calcification and inflammation. After menopause, this protective effect diminishes. If Lp(a) levels are high, this can accelerate the development of atherosclerosis, even in women who live healthily. Lp(a) may also play a role in pregnancy complications such as pre-eclampsia (high blood pressure and protein in the urine during pregnancy) and early cardiovascular problems after childbirth.

That’s why it’s recommended for women to test Lp(a) if they:

  • Develop heart or vascular disease before age 60.
  • Have a family history of heart attack or stroke.
  • Have experienced pregnancy complications such as pre-eclampsia.
  • Notice an increase in cholesterol or blood pressure after menopause.

What women can do

While you can’t change your Lp(a) level through diet or lifestyle, you can take steps to protect your heart:

  • Get tested, a single blood test can provide immediate insight in Lp(a) levels.
  • Pay attention to warning signs, like shortness of breath, fatigue, or pain between the shoulder blades can all signal heart issues.
  • Exercise regularly and follow a Mediterranean style diet.
  • Talk to your doctor about Lp(a) and your family history, especially if heart disease runs in your family.

Why this matters

Recognizing Lp(a) in women allows for earlier prevention and detection of cardiovascular disease. Testing for Lp(a) should be part of modern, personalized heart care, not only once symptoms appear, but to prevent them in the first place. A simple blood test can reveal whether genetic predisposition plays a role. That knowledge not only brings peace of mind, but also provides the opportunity to act years earlier and make informed, heart-healthy choices.

Sources
Scientific sources and medical references. The information on this page about lipoprotein(a), cardiovascular risk, and its specific impact in women is based on the following scientific publications and clinical guidelines:

Honigberg MC, Zekavat SM, Aragam K, et al.
Association of premature menopause with cardiovascular disease.
Circulation, 2019.
Provides evidence that the loss of hormonal protection in women is associated with an accelerated increase in cardiovascular risk around and after menopause.
https://pubmed.ncbi.nlm.nih.gov/30955264/

Kamstrup PR, Tybjærg-Hansen A, Nordestgaard BG.
Elevated lipoprotein(a) and risk of myocardial infarction in women and men.
Circulation, 2009.
Demonstrates that elevated Lp(a) significantly increases the risk of myocardial infarction in women as well as in men, with later but often more severe clinical presentation in women.
https://pubmed.ncbi.nlm.nih.gov/19620542/

Kronenberg F, Mora S, Stroes ESG, et al.
Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement.
European Heart Journal, 2022.
European consensus addressing heritability, sex-specific differences, life-stage considerations, and the importance of Lp(a) measurement in women.
https://pubmed.ncbi.nlm.nih.gov/36036785/

Burgess S, Ference BA, Staley JR, et al.
Association of LPA variants with risk of coronary disease and aortic valve stenosis.
JAMA Cardiology, 2018.
Genetic evidence demonstrating a causal relationship between elevated Lp(a) and cardiovascular disease in both women and men.
https://pubmed.ncbi.nlm.nih.gov/29926099/

Visseren FLJ, Mach F, Smulders YM, et al.
2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.
European Heart Journal, 2021.
Clinical guidelines with explicit attention to sex differences, hereditary risk factors, and cardiovascular prevention in women.
https://pubmed.ncbi.nlm.nih.gov/34458905/

 
 
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