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Low-cost lifestyle coaching, not just costly drugs, could help manage cardiovascular risk in people with elevated Lp(a), a review of behavioural approaches (Curr Opin Endocrinol Diabetes Obes 2021)

Original title: Novel behavioural approaches and implementation science for mitigating genetic risk of cardiovascular disease due to elevated lipoprotein(a)

Curr Opin Endocrinol Diabetes Obes · · 5

Mullan B, Chan D, Charlesworth J, Moullin J, Schultz C, Watts GF

This review by Mullan, Chan, Charlesworth, Moullin, Schultz and Watts examines novel behavioural strategies to mitigate cardiovascular risk in people with the genetic trait of elevated Lp(a). While pharmacological and biological Lp(a)-lowering interventions exist, their acceptability and feasibility are questioned due to cost and limited clinical evidence of efficacy. The authors instead highlight low-cost, minimal-patient-contact behavioural interventions targeting diet and physical activity, grounded in psychological theory, as particularly important for individuals with elevated Lp(a) who also face higher risk of familial hypercholesterolaemia and diabetes. The review concludes that such interventions can meaningfully improve diet and physical activity behaviours, with implications for developing similar programs specifically for people with elevated Lp(a).

Read the paper (DOI)PubMed

Original abstract

Purpose Of Review: Elevated lipoprotein(a) [Lp(a)] is a genetic trait that indicates higher risk of atherosclerotic cardiovascular disease (ASCVD). We review novel strategies to mitigate behavioural risk-factors in this genetic condition.

Recent Findings: Pharmacological and biological interventions are available for lowering Lp(a). However, the acceptability and feasibility of these approaches are questionable due to cost and lack of clinical evidence for their efficacy. A number of low-cost, minimal patient contact interventions are available for modifying behavioural risk-factors that are associated with increased risk of ASCVD familial hypercholesterolaemia and diabetes. These include lifestyle interventions designed to improve diet and physical activity. These interventions may be particularly important among individuals with elevated Lp(a) to manage their higher risk of diabetes and ASCVD. The following article outlines recent research that has examined such low-cost, minimal patient contact interventions.

Summary: The current research indicated that such interventions, which are grounded in psychological theory, can assist individuals to improve their diet and physical activity. These findings have implications for developing and implementing similar interventions for individuals with elevated Lp(a), so as to assist in reducing behavioural risk-factors associated with ASCVD.

diabetesfamilial hypercholesterolaemiatherapy

Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.