When The Biggest Loser trainer Bob Harper had a massive heart attack last year, it shocked the nation. Not only was this the guy who had whipped hundreds of contestants into shape, he was an absolute picture of wellness himself. His medical checkups showed that at age 52, he was in great health and that his cholesterol levels were perfect. So, what gives?
The doctors found that the culprit was lipoprotein(a) — a fatty particle in the blood. While HDL and LDL levels are routinely checked, lipoprotein isn’t. But perhaps it should be, as high lipoprotein levels triple the risk of having a heart attack or risk at a young age.
The exact role lipoprotein plays in the body is unknown. Some scientists believe that it helps to repair injured cells or prevent infections by binding to pathogens in the blood. However, when present in excessive amounts, it accelerates the formation of plaque in the arteries and creates blood clots. “It’s sort of a double whammy,” said Dr. Donald Lloyd-Jones, a cardiologist at the Northwestern University Feinberg School of Medicine. “Biologically, lipoprotein(a) both gets into the artery wall and causes damage there more easily.”
The good news is, the majority of people have very low levels of lipoprotein. The bad news is, it’s strongly determined by genetics, rather than lifestyle. In other words, even if you’re extremely fit and healthy, you could still be at risk if there’s a genetic history. The New York Times gives the example of 39-year-old Sandra Revill Tremulis. A medical device executive who moonlighted as an aerobics instructor, she followed a strict diet and maintained 16% body fat — on par with an elite athlete. Her cholesterol levels were low and her heart disease risk score put her odds of having a heart attack in her 40s at just 1%.
However, after struggling to finish her workouts due to extreme fatigue, she visited a doctor. Tests revealed that she had a 95% blockage in one of her coronary arteries, making her likely to have a heart attack within months. Further testing revealed she had high lipoprotein levels, which she believes she inherited from her father, who died of a heart attack at age 50. In a bid to raise awareness and advocate for wider lipoprotein, Sandra started a nonprofit, the Lipoprotein(a) Foundation.
So, until preventative screening for lipoprotein becomes more widespread, how can you mitigate your risk? Well, as always, it pays to be proactive. If you have a family history of heart disease, strokes or attacks, it’s worth asking your doctor to order a lipoprotein test, as well as having your usual cholesterol levels tested.