As mentioned earlier we are using a new technology in our office to help better define who is at higher risk of developing clogged arteries and to help tailor the best therapies to prevent heart attack and stroke.  Our new “toolbox” is the VAP profile and within that toolbox are a number of new tools in addition to the standard Total cholesterol, HDL (good), LDL (bad) and triglycerides.  One of those tools is checking for something called Lipoprotein (a) or Lp(a) for short.  Lp(a) is a  cousin to a protein called plasminogen which helps break down blood clots.  In people who have high levels of Lp(a) the plasminogen doesn’t work as well and hence they may be more prone to form dangerous clots.  If you have a high Lp(a) level you may benefit from being on even more aggressive weight loss and exercise programs as well as appropriate medication to help lower  risk.  Lp(a) problems can run in families particularly those where heart attacks have occurred at an early age.  Lp(a) levels generally should be less than 10 but tend to run higher in African Americans.  We will discuss other tools in our new VAP toolbox in upcoming posts.