Studies have shown that people with high levels of a protein called lipoprotein(a) or Lp(a) are more at risk of developing heart disease and having a stroke. However, most of these studies have been done overseas using largely European populations. Now, for the first time, HRC Pacific postdoctoral fellow Dr Allamanda Fa’atoese is exploring whether Lp(a) levels might be a good predictor of heart disease among New Zealand’s Pacific population and what this might mean for heart disease screening in this country.
Allamanda, a New Zealand-born Samoan, first became interested in researching Lp(a) levels during her PhD work on the HRC-funded Hauora Manawa – Community heart study at the University of Otago, Christchurch. After analysing the study participants’ lipid profiles she found, to her surprise, that rural Māori in Christchurch had significantly lower levels of Lp(a) compared with the urban Māori and non-Māori groups, even though the rural Māori group had a high risk of cardiovascular disease according to other measures like blood pressure.
Her findings got her wondering: what would the lipid profiles of New Zealand’s Pacific community reveal?
"The number of people dying from cardiovascular disease remains consistently higher for Māori and Pacific populations compared to their New Zealand European counterparts. Lp(a) is an independent marker for cardiovascular disease which is largely controlled by genetics, rather than age, gender or traditional lifestyle factors. However, before we can know if these lipoproteins are going to be effective markers of cardiovascular risk in our Pacific community, we first need to establish what normal levels are," says Allamanda.
To find this out, Allamanda has recruited 200 Pacific adults (20–64 years) who are registered with Pacific Trust Canterbury, a whānau ora provider for Pasifika in Christchurch. She is currently analysing their blood samples, measuring Lp(a) levels and other new markers such as Lp-PLA2, and assessing a range of cardiovascular risk factors.
"Identifying people at higher risk of cardiovascular disease through a combination of established risk screening and novel lipoprotein biomarkers is a preventative strategy. But we will only eliminate the ethnic disparities associated with cardiovascular disease if markers like Lp(a) are similarly effective in predicting the risk of cardiovascular disease across the different ethnic groups in New Zealand."
Allamanda says the HRC Pacific postdoctoral fellowship has given her the opportunity to lead this study and learn a raft of new skills.
"It’s been challenging, but great for my personal development because I’m involved in all areas of the study, from interviews and recruitment, to sample taking and lab work. It’s also the first time that our group has collaborated with Pacific Trust Canterbury, which has been fantastic."
Allamanda says she hopes to establish the cardiovascular risk profile of the study’s Pacific Christchurch group and identify those who might go on to have a coronary event. The GP clinic at Pacific Trust Canterbury will follow up with any participants who might be diagnosed with risk factors as a result of the blood samples taken for the study. She says ideally it would be good to then extend this research across New Zealand.
"I have a strong family history of premature heart disease and type 2 diabetes, so I have a vested interest in improving the cardiovascular health outcomes of our Pacific peoples," says Allamanda.