Question 1

How is the Lp-PLA2 test different from other cholesterol tests?

Accepted Answer

Unlike general cholesterol panels or hs-CRP which reflect systemic inflammation, Lp-PLA2 specifically measures active inflammation within atherosclerotic plaques in artery walls. Research suggests that Lp-PLA2 may better show who is at risk for heart disease and stroke than HDL, LDL, and VLDL cholesterol alone. A patient with normal LDL but elevated Lp-PLA2 has a very different cardiovascular risk profile than LDL alone would suggest, as Lp-PLA2 captures the inflammatory vulnerability of existing plaques.

Question 2

What can cause elevated Lp-PLA2 levels?

Accepted Answer

Lp-PLA2 is produced by macrophages and other inflammatory cells and is expressed in greater concentrations in advanced atherosclerotic lesions. Levels correlate with age, BMI, current smoking, and history of hypertension. People who have a history of gum disease have significantly higher Lp-PLA2 levels, suggesting that good oral hygiene can reduce risk. Additionally, certain medical conditions that promote arterial inflammation can elevate Lp-PLA2 levels.

Question 3

How often should I have this test done?

Accepted Answer

Lp-PLA2 has demonstrated modest intra- and inter-individual variation, commensurate with other cardiovascular lipid markers and substantially less variability than high sensitivity C-reactive protein. The frequency of testing depends on individual cardiovascular risk factors, existing conditions, and healthcare provider recommendations. For individuals with elevated baseline levels or high cardiovascular risk, periodic monitoring may be beneficial to assess the effectiveness of risk reduction strategies. Those with optimal levels and low cardiovascular risk may require less frequent testing.

Question 4

Can lifestyle changes affect my Lp-PLA2 levels?

Accepted Answer

Lp-PLA2 activity can be reduced by treatment with lipid-lowering therapies, increased omega-3 fatty acid intake, and lifestyle modifications. Good oral hygiene, including daily brushing and flossing along with regular professional teeth cleaning, can help reduce Lp-PLA2 levels. Regular exercise, maintaining a healthy weight, not smoking, and following a heart-healthy diet rich in omega-3 fatty acids may help reduce arterial inflammation and subsequently lower Lp-PLA2 levels.

Question 5

What should I do if my Lp-PLA2 levels are elevated?

Accepted Answer

Clinical management may include beginning or intensifying risk reduction strategies. However, Lp-PLA2 is not diagnostic for heart disease or stroke, it is just an indicator of risk. Many with elevated levels will not develop these conditions, while some with normal levels will. Elevated levels warrant discussion with a healthcare provider about comprehensive cardiovascular risk assessment and potential interventions such as lifestyle modifications, dietary changes, exercise programs, or medical treatments to reduce cardiovascular risk and arterial inflammation.

Lp-PLA2 (PLAC Test)