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

Barbara Mullan, Dick Chan, Jessica Charlesworth, Joanna Moullin, Carl Schultz, Gerald F Watts

Journal: Current opinion in endocrinology, diabetes, and obesity 2021;28(2):174-180

PMID: 33395090

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.

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Address: Faculty of Health Sciences, School of Psychology, Curtin University, Bentley.; Faculty of Health and Medical Sciences, School of Medicine, University of Western Australia, Perth.; Faculty of Health Sciences, School of Pharmacy and Biomedical Sciences, Curtin University, Bentley.; Faculty of Health and Medical Sciences, School of Medicine, University of Western Australia, Perth.; Department of Cardiology.; Faculty of Health and Medical Sciences, School of Medicine, University of Western Australia, Perth.; Department of Cardiology, Lipid Disorders Clinic, Cardiometabolic Services, Royal Perth Hospital, Perth, Western Australia, Australia.
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