Background & Rationale
Lipoprotein(a) [Lp(a)] is a genetically determined, independent risk factor for atherosclerotic cardiovascular disease (ASCVD), with limited pharmacological treatment options currently available. However, lifestyle modifications may help mitigate ASCVD risk, even in individuals with elevated Lp(a). The American Heart Association’s (AHA) Life’s Essential 8 provides a comprehensive measure of cardiovascular health, integrating lifestyle and clinical factors.
Existing studies have focused on Lp(a) as a fixed, non-modifiable risk factor, but limited research has explored how adherence to optimal cardiovascular health affects ASCVD risk among individuals with high Lp(a) levels. Additionally, whether these associations differ by race, sex, and ASCVD onset timing (premature vs. later-onset ASCVD) remains unclear. This study will leverage the UK Biobank’s extensive dataset to address these knowledge gaps.
Research Objectives
To examine the association between AHA Life’s Essential 8 cardiovascular health scores and ASCVD incidence in individuals with high Lp(a) levels, stratified by race, sex, and ASCVD onset (premature vs. later-onset).
To assess whether adherence to optimal cardiovascular health (as defined by Life’s Essential 8) modifies ASCVD risk in individuals with high Lp(a), independent of lipid-lowering therapies, and to determine if this effect varies by race, sex, and ASCVD onset timing.
To investigate interactions between Lp(a) levels and individual components of Life’s Essential 8 in relation to ASCVD risk and metabolic health, and to evaluate whether these associations differ across racial groups, clinical subgroups, and ASCVD onset categories.
