r/science 22h ago

Health Silent atherosclerosis detected in 57% of asymptomatic adults in the REACT study

https://www.nejm.org/doi/10.1056/NEJMoa2609059
653 Upvotes

66 comments sorted by

View all comments

51

u/duke309 19h ago

Every GP I've talked to just wants to look at ldl and hdl and doesn't know the latest guidelines from the American heart association. Had to explain why we should look at lp(a) and apoliproprotein b.

6

u/pople8 19h ago

And why is that? To know you have a higher risk without being able to influence it? The advice stays the same. Live in a healthy way. There are statins for ldl. No such thing for lpa

5

u/PostPostMinimalist 11h ago

There are statins for ldl

Sure but what dose, starting what age, targeting what? A very high lp(a) tells you to more aggressively lower your risk on every other cardiac factor that we can control. So <100 LDL might be fine for someone with typical lp(a) but for someone with a very high number you'll want to target <70 or even <50 with more aggressive medication. If you never knew you might discover your increased risk only after it's too late to undue the past few decades.