Thanks, Carolyne, for sharing and asking. One thing upfront: please don’t take my answer as medical advice. I can only explain the current state of the literature as I see it.
First question: “First, what are your thoughts on the age-old beats per minute reading based on age subtracted from 220”
That’s simply a rule of thumb and not the best one. The Tanaka formula has a better fit across populations (HRmax = 208 − 0.7 × age). Keep in mind that this is an estimate of your HRmax. You can try to push yourself to the limit and see how high your HR goes (at the highest level of exertion that you can maintain for 30 seconds). That’s your actual HRmax. Neither the actual HRmax nor the derived HRmax are indicators of fitness. They only help you to identify the training zones within which you want to work out to elicit the desired fitness goals.
Regarding your second question about LP(a), Given your “bionic” lipid and health profile (I’d be interested to know the actual values) you would probably not have been tested for LP(a) in the first place. Unless, of course, your 10-year risk estimation for fatal CVD events was >3% in Europe, or > 10% (fatal and non-fatal) in the US. LP(a) varies widely between individuals (up to 3 orders of magnitude, which is huge) with people of African descent generally having higher levels. Yes, elevated LP(a) is a risk factor for valve calcification and for faster progression of coronary artery calcification. Keep in mind “Risk factor” does not mean that you will inevitably suffer the consequences. So, only when other risk factors identify you as a higher-risk individual will LP(a) testing make sense. But you did it anyway, so keep an eye on your CAC score and see how it progresses, if at all. I assume that your doctor told you how you can try to reduce your LP(a): with a daily supplementation of Niacin (Vit B3).
Your last question: “how does ensuring that I keep my CRF rate optimal potentially stave off the nasty ramifications of a high LPA?” To use a simple metaphor: by teflonizing your arteries. You’ll know from some of my other posts that the integrity of endothelium, the inner lining of the arteries, is essential to maintaining arterial health and preventing atherosclerosis. Higher fitness requires higher-intensity exercise which stresses the endothelial cells in a favorable way that helps them keep this inner lining intact. I’ll have another article out probably this week, which addresses this subject in greater detail.
