Lipoprotein(a), often written as Lp(a), is a type of lipoprotein particle that is structurally similar to LDL cholesterol but carries an additional protein called apolipoprotein(a). Unlike most other cholesterol markers, Lp(a) levels are almost entirely determined by genetics. Diet, exercise, and most cholesterol-lowering medications including statins have little to no effect on Lp(a) concentration.
Elevated Lp(a) is an independent risk factor for cardiovascular disease, including heart attack, stroke, and calcific aortic valve disease. It is estimated that 20 to 25% of the population has Lp(a) levels above the elevated threshold. Many of these people have completely normal standard cholesterol panels, which is why Lp(a) is sometimes described as a hidden or unmeasured cardiovascular risk factor. Standard lipid panels do not include Lp(a), so it must be ordered separately.
Because Lp(a) is genetically fixed and does not fluctuate meaningfully over time, you generally only need to test once in your lifetime. That single result establishes your baseline and helps your practitioner stratify your long-term cardiovascular risk. If Lp(a) is elevated, it does not change the cholesterol targets themselves, but it may prompt your practitioner to take a more proactive approach to managing other modifiable risk factors.
This test is particularly relevant for people with a family history of premature cardiovascular disease, those who have experienced a cardiovascular event despite normal LDL cholesterol, and anyone wanting a thorough assessment of their cardiovascular risk profile. No fasting is required, and the result is not affected by meals, exercise, or time of day.
Treatment options specifically targeting Lp(a) are currently limited, though emerging RNA-based therapies are in clinical trials. Your cardiologist or GP can advise on the current landscape if your level is elevated.
This test identifies whether you carry elevated Lp(a), an independent genetic cardiovascular risk factor. Elevated Lp(a) increases the risk of heart attack, stroke, and aortic valve disease, irrespective of other cholesterol levels. It's particularly relevant for people with a family history of early heart disease or cardiovascular events despite otherwise normal cholesterol.
