{"id":82166,"date":"2025-05-09T11:09:32","date_gmt":"2025-05-09T17:09:32","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=82166"},"modified":"2025-05-09T11:29:17","modified_gmt":"2025-05-09T17:29:17","slug":"lipid-apheresis-keeps-familial-high-cholesterol-in-check","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/lipid-apheresis-keeps-familial-high-cholesterol-in-check\/","title":{"rendered":"Lipid apheresis: An \u2018oil change for the bloodstream\u2019 can keep cholesterol in check"},"content":{"rendered":"
<\/div>
\"Genetic
Genetic factors lift Diana Joy Albertsen\u2019s cholesterol levels sky-high. Lipid apheresis brings them back to earth. \u201cI can live my life and play with my grandkids,\u201d she says, holding granddaughter Daisy, 9 months. Photo by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n

Diana Joy Albertsen ate right and exercised. Between that and working, volunteering, and managing her and husband David\u2019s busy Arvada household of three biological and five foster kids, it was no surprise that her five-foot-one frame carried a lean 100 pounds.<\/p>\n

Yet despite taking cholesterol-lowering drugs, her \u201cbad\u201d cholesterol numbers<\/a> \u2013 for low-density lipoprotein (LDL) cholesterol \u2013 were generally stuck at 1.5 times or more than the typical upper bound for intervention, which is 100 mg\/dL. By her mid-forties, Albertsen had survived three heart attacks, and five stents were keeping her coronary arteries open.<\/p>\n

There would be 14 more years of angina<\/a> and other health scares until Albertsen, now 61, found an effective treatment. Called lipid apheresis<\/a>, it involves pumping the patient\u2019s blood through a machine that removes dangerous fat particles. Think of it as a sort of oil change for the bloodstream. She does a roughly three-hour session once every two weeks at the Cardiometabolic and Advanced Lipid Disorders Clinic<\/a> at UCHealth University of Colorado Hospital on the Anschutz Medical Campus, the only center in the region offering lipid apheresis.<\/p>\n

A genetic predisposition for sky-high bad cholesterol<\/strong><\/h2>\n

Albertsen is far from alone in the fight against cholesterol.\u00a0For most, dietary and lifestyle changes, plus drugs such as\u00a0statins,<\/a> can keep the problem in check.<\/span>\u00a0But she\u2019s among the roughly one in 250 people whose familial hypercholesterolemia<\/a> (FH) makes controlling cholesterol much harder. FH is hereditary, and only about one in ten people with FH even know they have it. That\u2019s scary, because those with untreated FH have a lifetime stroke and heart attack risk about 20 times higher than that of the general population.<\/p>\n

\"Albertsen
Albertsen with husband David, daughter Savannah, and granddaughter Daisy. Photo by Cyrus McCrimmon for UCHealth.<\/figcaption><\/figure>\n

What\u2019s more, Albertsen is among the roughly 20% of the population with a genetic predisposition for unhealthy levels of lipoprotein(a)<\/a>, or Lp(a), an LDL cholesterol particle that\u2019s bonded with a protein. Lp(a) doesn\u2019t respond to diet and exercise, it\u2019s not detected by standard blood panels, and it can lead to atherosclerosis<\/a>, thrombosis<\/a>, and, aortic valve calcification<\/a>. Lipid apheresis is the only U.S Food and Drug Administration-approved treatment for reducing Lp(a).

Lipid apheresis reduces average LDL cholesterol by about 40% and average Lp(a) levels by about 25%, lowering the risk of cardiovascular events such as heart attacks, strokes, or a peripheral arterial disease (PAD) blockage by 50% to 85%.<\/div>\n

\u201cPatients have done diet and exercise for years and years and years. They\u2019re taking maximum doses of statins or they can\u2019t tolerate statins, and they\u2019re still having cardiac events,\u201d said Melissa Nasser, a clinical nurse who oversees lipid apheresis sessions at UCHealth.<\/p>\n

Albertsen is among those who can\u2019t tolerate statins. Like many with FH and\/or high Lp(a) levels, it took years to arrive at a diagnosis. That\u2019s despite her father having died of a heart attack at 62 and two brothers and a sister also having had heart attacks. It took more years and many heart scares for lipid apheresis to come into play.<\/p>\n

\u201cTheir cardiologists throw up their hands, saying, \u2018We\u2019ve tried everything,\u2019\u201d Nasser said. \u201cA lot of them don\u2019t know that this exists, or that it\u2019s an option.\u201d<\/p>\n

Lipid apheresis is gaining awareness<\/strong><\/h2>\n
\"Albertsen\u2019s
Albertsen\u2019s LDL-C results over time show how her LDL-C rises between lipid apheresis sessions and then plunges by the end of the session. Courtesy of Diana Joy Albertsen.<\/figcaption><\/figure>\n

That\u2019s finally changing, said Dr. David Saxon<\/a>, the University of Colorado School of Medicine endocrinologist who directs UCHealth\u2019s Lipid Apheresis Program as well as CU\u2019s Cardiometabolic & Advanced Lipid Clinic.<\/a> A recent American Heart Association statement on lipid apheresis and the numbers it reported have been catalysts, he says.<\/p>\n

Lipid apheresis reduces average LDL cholesterol by about 40% and average Lp(a) levels by about 25%, lowering the risk of cardiovascular events such as heart attacks, strokes, or a peripheral arterial disease (PAD<\/a>) blockage by 50% to 85%. Among the other benefits include reduced angina, better exercise tolerance, better blood flow to the heart, and better leg-wound recovery among those with PAD. The American Heart Association statement\u2019s authors say 11,000 to 15,000 patients nationally could benefit from lipid apheresis \u2013 more than 25 times the 400 or so U.S. patients who currently access it, \u201cunderscoring the barriers to access and likely lack of awareness of its benefits and indications.\u201d<\/p>\n

Lipid apheresis takes out the bad, leaves the good cholesterol<\/strong><\/h2>\n

During a recent biweekly lipid apheresis session, Albertsen reclined in a UCHealth Dialysis Center clinic room (lipid apheresis and hemodialysis<\/a> machines are different, but the setup and general idea of ridding the blood of unwanted elements are similar). She squeezed a green grip ball to help keep the blood flowing from a vein in her left forearm and through a thin crimson-filled line. An occasional beeping and red light led Nasser to subtly adjust the machine\u2019s flow.<\/p>\n

\u201cHaving this treatment is 100 times better than going through life not knowing and experiencing symptoms,\u201d Albertsen said.<\/p>\n

\"Albertsen\u2019s
Albertsen\u2019s LDL-C rises between lipid apheresis sessions and then plunges by the end of the session \u2013 in the most recent case, from 114 ml\/dL to 50 mg\/dL. Courtesy of Diana Joy Albertsen.<\/figcaption><\/figure>\n

Her blood will pass through the Kaneka machine more than twice during the roughly two-and-a-half hours she\u2019s hooked up to it. The machine first separates the plasma from the incoming blood (plasma makes up about 55% of blood volume), then uses negatively charged microscopic beads to trap LDL cholesterol, lipoproteins and triglycerides. High-density cholesterol \u2013 \u201cgood\u201d cholesterol \u2013 is much less affected and mostly remains in the plasma. IV fluid is mixed in to make up for water loss during filtration, and another crimson-filled line leads back to a vein in Albertsen\u2019s right forearm.<\/p>\n

Boosting energy for patients with familial high cholesterol<\/strong><\/h2>\n

By the time the session\u2019s over, Albertsen will have about 80% less LDL cholesterol and 70% less Lp(a) in her bloodstream. (The averages cited above are lower, because the fat particles build up during the two weeks between lipid apheresis sessions.) Also, liquid apheresis turns the consistency of Albertsen\u2019s blood from something like tomato soup to more like tomato juice, Nasser says. That lower viscosity means less work for the heart and better odds against clotting.<\/p>\n

Albertsen says liquid apheresis treatments have boosted her overall energy.<\/p>\n

\"Lipid
Lipid apheresis has given Diana Joy Albertsen more energy and less worry, allowing her to enjoy her life with her family. Here, she holds her granddaughter Daisy. Photo by Cyrus McCrimmon, for UCHealth.<\/figcaption><\/figure>\n

\u201cI did a lot, but I was always tired,\u201d she said. Now, she added, \u201cI can live my life and play with my grandkids.\u201d<\/p>\n

Her husband, David, agreed.<\/p>\n

\u201cShe has more energy. She\u2019s mentally a lot more positive about things \u2013 and her health also,\u201d he said.<\/p>\n

Albertsen has even come to appreciate the time she spends with Nasser and UCHealth colleagues during her lipid apheresis sessions.<\/p>\n

\u201cThey understand what you\u2019re going through. They understand your fears. When I walked in here, I didn\u2019t feel alone with it,\u201d she said. \u201cThey become<\/p>\n

your family.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Diana Joy Albertsen ate right and exercised. Between that and working, volunteering, and managing her and husband David\u2019s busy Arvada household of three biological and five foster kids, it was no surprise that her five-foot-one frame carried a lean 100 pounds. Yet despite taking cholesterol-lowering drugs, her \u201cbad\u201d cholesterol numbers \u2013 for low-density lipoprotein (LDL) […]<\/p>\n","protected":false},"author":23,"featured_media":82170,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6,7],"tags":[1024,3512,128,9250,551],"class_list":["post-82166","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","category-stories","tag-blood-disorders-disease-care-hematology","tag-heart-and-vascular-care-cardiovascular","tag-heart-health","tag-ldl-apheresis","tag-weight-and-metabolism"],"acf":[],"yoast_head":"\nLipid apheresis keeps high bad cholesterol in check - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Lipid apheresis awareness is growing; 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He covered science and the environment for the Daily Camera in Boulder, Colorado, and has taught narrative nonfiction at the University of Colorado, where he was a Ted Scripps Fellowship recipient in Environmental Journalism. 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