Lipoprotein(a) in Finnish adults: Prevalence, Awareness, and Cardiovascular risk associations

Abstract Background We aimed to assess Lp(a) levels in the Finnish population and its association with the prevalence of awareness, treatment, and control of cardiometabolic risk factors by Lp(a) status. Methods The study population consisted of 5544 (56% of the sample) individuals aged 20-97 who participated in the health examinations, survey and blood sampling in the nationally representative Healthy Finland study in 2023. High Lp(a) was defined as ≥ 125nmol/l (approx. 50 mg/dl). Cardiometabolic risk factors included dyslipidemia, abnormal glucose metabolism, high blood pressure, and obesity. Analyses were adjusted for age. Results The median (and mean) Lp(a) levels were 14 nmol/L (42.0 nmol/L (SD 59.5)) in men and 16 nmol/L (42.9 nmol/L (SD 61.6)) in women, with 11.3% of men and 10.8% of women exceeding 125 nmol/L. Dyslipidemia was more prevalent in men (93.6% vs. 83.0%) and women (79.4% vs.73.4%) with high Lp(a) compared to those with lower Lp(a). After correcting dyslipidemia for Lp(a), the association in men disappeared (79.9% vs. 80.7%), and in women, dyslipidemia was less common in those with high Lp(a) (63.0% vs. 70.3%). Lp(a) levels were not associated with other cardiometabolic risk factors. While Lp(a) level were unknown to subject, higher Lp(a) levels were nevertheless associated with greater awareness (60.5% vs. 52.3% in men and 64.5 % vs. 52.6 % in women), treatment levels (41.5% vs. 31.9% in men and 33.8% vs. 25.4% in women), and control (57.4% vs. 41.4% in men and 49.2% vs. 30.4%in women) of dyslipidemia. Conclusions About 11 % of the Finnish population has high Lp(a). Higher Lp(a) was associated with prevalence of dyslipidemia, which may explain why higher Lp(a) was also associated with better awareness, treatment, and control of dyslipidemia. Lp(a) levels were not associated with other cardiometabolic risk factors. Optimal management of modifiable risk factors is recommended for individuals with high Lp(a). Key messages • 11% of the Finnish population have high Lp(a). Subjects with higher Lp(a) have better awareness, treatment, and control of dyslipidemia, presumably through the association of Lp(a) and dyslipidemia. • In individuals with high Lp(a), optimal management of modifiable cardiometabolic risk factors is crucial and therefore greater awareness of Lp(a) is needed.