**Episode Title: "Day 07: Lipoprotein (a) - The Hidden Risk"** **Host:** Good to see you! Welcome back. We're halfway through, and today we're talking about lipoprotein little a, or Lp(a), or lipoprotein A. Well, is this important? You bet it is! In recent years, we've really started to appreciate that this particular particle that floats around in the bloodstream can be linked with accelerated atherosclerosis. It can also be linked with aortic valve problems, believe it or not. We've talked about the particles in the bloodstream before, and we've mentioned high-density lipoprotein, the so-called good guy, HDL. We've mentioned LDL, the so-called bad guy, low-density lipoprotein. Well, lipoprotein A is just the same as the LDL particle, but it has a special wraparound. That little wraparound is like a bit of barbed wire, and as that particle floats through the body, that little bit of barbed wire gets caught on things— a bit like a bit of barbed wire getting caught on a woolen jumper. Now, because that particular protein that's wrapped around LDL cholesterol, creating Lp(a), gets caught on things, it means it's got a greater chance of giving up its cholesterol into atherosclerotic plaque. That same little barbed wire protein around LDL can also drive inflammation and can increase the risk of clotting as well. So, this is a really nasty little particle. What we find is that the levels in you or I don't really alter that much in our lives. They do a bit in pregnancy, and if our kidneys fail, they'll change. If you measure it as a newborn, it'll be a bit on the low side, but a couple of years later, you've got your level pretty well for life, and that's come from your parents. It's really interesting; it runs in families. So, if we see families with premature coronary disease, we will generally check for lipoprotein A. Now, up until recently, there hasn't really been anything on offer to treat it or lower it, so it hasn't been much of a priority. But recent technologies are allowing us the chance to really look at ways to comprehensively reduce this little particle out of the bloodstream. So, watch this space. Lipoprotein A, it's recommended everyone get it tested at least once in their life. If there is premature coronary artery disease in the family, think about getting it checked in your family. Well, I hope you enjoyed that. I'm pretty keen to talk about exercise and the impact that has on your cardiovascular health, so stay tuned. For now, I hope you live as well as possible for as long as possible. Take care and bye!