What is meant by emerging risk factors for heart disease?
The NCEP ATP III guidelines discuss a number of emerging risk factors for heart disease, including small, dense LDL and lipoprotein (a), or Lp(a). LDL is not present in the circulation as one well-defined structure; but rather it is present as a continuum of size and density. The presence of small, dense LDL quadruples the risk of heart disease compared with the same total LDL concentration present in a large, buoyant form. Lp(a) is a genetic risk factor that has been shown to be 10 times more atherogenic than LDL on a mg per deciliter basis. Thus, it is important to measure Lp(a) in patients with a family history of premature atherosclerosis. Importantly, these emerging risk factors are not measured by the routine lipid panel.
