Most readers of these columns, I assume, are aware of the relation between elevated cholesterol and coronary heart disease, and of the benefit of reducing high cholesterol with diet and medication. The statins have saved many lives, and newer agents have come to market for those who cannot take statins.

            I do hope you are not among the third of Americans who do not know their cholesterol.

            What I would like to discuss here is another heart risk factor, which has been prominently discussed recently in the cardiology community but has not received much attention more widely. This is lipoprotein(a), commonly referred to as Lp(a) and verbalized as “L p little a.”

            Lp(a) is an LDL (low density lipoprotein) molecule with an apo(a) protein attached. It can be trapped in the arterial wall, causing atherosclerosis (“hardening of the arteries”) and it increases clotting.

            We know a lot about Lp(a.) It is genetically determined; there is very little effect of diet on levels. This means that you don’t need to measure it on a regular basis – if it is high, it will stay high, and if it is low, it will stay low.

            It is a major factor in causing coronary disease, independent of standard cholesterol values.

            As of now, there are no medications available to lower it, but new medicines are on the horizon.

            If we cannot treat it, you may ask, why measure it?

            First, if it is elevated, your doctor can put you on cholesterol-lowering medication even if your standard cholesterol levels are normal and would not be treated. No one risk factor works alone, and even if we cannot yet lower a high Lp(a), we can still reduce your risk of heart attack by treating other risk factors.

            Second, there is recent evidence that low-dose daily aspirin, which is now considered not appropriate for the general population, will cut in half the heart-attack and stroke risk in people with Lp(a) over 50.

            So, at your next visit, ask your doctor if they have ever measured your Lp(a), and request they do so if it has never been done.

            Knowledge is power.

Dr. Ed Hoffer is the chairman of the Marion Board of Health, a graduate of MIT and Harvard Medical School. He is Associate Professor of Medicine, part-time, at Harvard and a Senior Scientist at the Massachusetts General Hospital.

By Dr. Ed Hoffer

            How many times do I have to write about this, people? This is the third column I have devoted to the now infamous Mattapoisett “Big Dig” or, as one wag has called it, the deforestation of paradise.

            I am of course referring to the proposed cutting down of multiple trees as part of an immense road reconstruction project along our historic and scenic roadway that meanders along the shore of the town’s picturesque harbor. The plan, as I have written before, promises to alter the way the iconic village looks for generations to come.

            The latest version, created by engineers – don’t get me started on engineers; my blood pressure is high enough already – which has already been approved by the Select Board and the regulators at the state level, is moving on, ever so slowly to a sometime-in-the-future completion.

            Currently 26 trees are scheduled to be removed, a number that has raised the hackles of many, including the town’s Tree Committee, which is planning an upcoming informational meeting.

            As I recall, there were several sparsely attended public hearings held back in 2017 to gauge the sense of the community about the proposed project. My ever-fading memory vaguely recalls that trees were a major topic of conversation and consternation.

            One might have expected a survey to follow, but none was forthcoming despite the fact there seems to have been one for every project that comes down the line. There was one for the Holy Ghost Grounds project, the Route 6 reconstruction, the Master Plan, the merger of the elementary schools and even one inquiring about what hours the Town Hall should be open to the public. But none, so far, for trees.

            If senior citizens were asked, I am sure they would rue the loss of summer shade on their afternoon walks. And, if all the male dogs in town were able to respond (they are experts on trees you know), they would say the plan is barking up the wrong tree.

            It seems that a rumor has been planted that the Select Board would not allow the Tree Committee to identify the trees to be felled. Hmmmm … is secrecy afoot in the administrative branch of our government? Are there shady deals lurking in the recesses of Town Hall designed to chop down the people’s right to know? I sense a “Treegate” controversy is budding.

            In an effort to get to the root of this matter, I decided to put on my investigative reporter hat and seek the guidance of my ever-reliable, secret, confidential source in town government.

            Why, I asked my mole, is the Tree Committee not allowed to identify which of our towering timbers are doomed to the roar of chain saws? Well, apparently, there is an official bylaw that prohibits the posting of notices, except for official ones, of any kind on town trees. Who knew?

            Does this include tying yellow ribbons around our old oak trees, I wondered. Yup, it does.

            Well, in true rebellious fashion, suddenly 11 trees now have acquired yellow ribbons. As I write this, the culprits of this defiant deed remain unknown to this scribe. Have the powers that be seen the error of their ways and elected to grant a waiver of the offending bylaw? Who knows?

            Oak-y-doke then, let me go out on a limb, here’s a seed of an idea. If every person who posted a notice of a lost dog or cat, or a yard-sale announcement were caught, the town would harvest a fortune in fines, right? If we used the fines to self-fund the road project, we wouldn’t have to cut down our precious seaside trees.

            Or … we could just risk waiting for Mother Nature to do what she does. I recall when I was a mere sapling, there were no trees in the village, all having been felled by hurricanes. The trees we now cherish are the replacements for old Mother’s stiff winds.

            Well, I have said enough. I am stumped as to how to solve this dilemma. I guess it is time to leaf this issue to others.

            Editor’s note: Mattapoisett resident Dick Morgado is an artist and retired newspaper columnist whose musings are, after some years, back in The Wanderer under the subtitle “Thoughts on ….” Morgado’s opinions have also appeared for many years in daily newspapers around Boston.

Thoughts on…

By Dick Morgado