Lipoprotein(a): A Cardiovascular Risk Factor Affecting Ethnic Minorities

Lipoprotein(a) is a plasma circulating apoB100 (apoB) containing lipoprotein. It has a unique glycoprotein bound to the apoB100, apolipoprotein(a) [apo(a)]. Most individuals have two circulating isoforms in plasma. Its levels are mostly genetically determined. Studies in large populations have established elevated levels of Lp(a) to be a causal risk factor for the development of cardiovascular disease. Lp(a) levels differ across ethnic groups and Black individuals of sub-Saharan descent have higher levels when compared to White individuals. Published genetic and epidemiological studies lack inclusion of large minority populations, highlighting a need in the field. There is a lack of standardization in the commercial assays used to measure Lp(a) levels, and hence it is difficult to assess risk based on individual Lp(a) levels. The risk seems to occur in the upper five percentile of the population. In this chapter, we highlight Lp(a) biology and physiology with a focus on available data from ethnically diverse cohorts. We include the latest findings from these cohorts and discuss future directions on treatments in the field.