Harpreet Bhatia, MD: Benefits of Universal Screening for Lp(a) Levels

Harpreet Bhatia, MD, from the University of California San Diego, presented the session “Universal Lp(a) Screening Why Screen Now?” at the Family Heart Global Summit on September 23, 2024, in Dallas, Texas.h

HCPLive spoke with Bhatia at the summit who discussed the advantages of universal screening for Lipoprotein(a) (Lp(a)) levels. He explained ≥ 20% of the global population has high Lp(a) levels, which indicates an increased cardiovascular risk.

Evidence from epidemiologic and genetic studies has consistently shown the elderly are associated with an increased risk for multiple cardiovascular diseases, such as aortic valve disease and coronary heart disease. Since many older adults have high Lp(a) levels, Bhatia emphasized the importance of universal screening.

“To screen among the general population, you have to screen 5 people to find 1, in general, who has an elevated level,” Bhatia said. “So that's one argument for universal screening. Another argument is that the actual level itself is actionable, that there are things that we can do that will change a patient's management based on the level.”

Bhatia said it is possible to incorporate the increased cardiovascular risk associated with Lp(a) levels in prediction models to assess someone’s risk in 20 or 30 years. Completing universal screenings will also help tailor individualized therapies since they will have access to other cardiovascular risk factors such as lifestyle, blood pressure, other cholesterol measures, healthy diet, weight, and non-smoking,

“Optimizing all of that does improve risk among people with high Lp(a),” Bhatia said, “and identifying the Lp(a) level can be both a motivating factor and a way to identify people who should get the most aggressive risk factor modification.”

Universal screening will also be effective in primary or secondary prevention of cardiovascular diseases. High LP(a) levels may run in families, and this will make the screening process smoother.

“It’s very effective to be able to identify people across a family tree who have high LP(a) levels have just increased risk to get more targeted management,” he said.

Bhatia said another argument for universal screening is its simplicity.

“I think if we over-complicate things, and we have lots of caveats and lots of subgroups and targeted, recommendations for screening, I think [there will be a] …longer screen[ing], which are already terrible,” Bhatia said. “If we [use]… universal screening, I think we will identify many more people at risk or candidates for some of these management strategies.”

References

^{Bhatia, H. Universal Lp(a) Screening Why Screen Now? Family Heart Global Summit 2024 on September 23, 2024, at Dallas, Texas.}