Quick version
Lipoprotein (a) is a hereditary risk factor for cardiovascular disease. Approximately one in five people has elevated levels, which can contribute to atherosclerosis and an increased risk of heart attack or stroke – even in individuals with otherwise normal blood lipid levels and a healthy lifestyle. The level is almost entirely determined by genetics and is only minimally affected by diet, exercise, or standard cholesterol-lowering medications.
A simple blood test can measure Lp(a), and since the value remains stable throughout life, testing once is usually sufficient. An elevated level does not necessarily mean that you will develop disease, but it can be an important piece of the overall assessment of cardiovascular risk.
What is lipoprotein (a)?
Lipoprotein (a) is a particle in the blood that transports cholesterol. It resembles LDL cholesterol, often referred to as the “bad” cholesterol, but it also contains an additional protein component called apolipoprotein(a). This added component is what distinguishes Lp(a) from regular LDL and may pose a specific risk. The level of Lp(a) is almost entirely determined by our genes. This means that the level is largely predetermined from birth and is minimally influenced by lifestyle.
What role does Lp(a) play in the body?
Researchers do not yet know exactly what function Lp(a) has. It is believed to be involved in the body’s healing processes and in how the blood clots. Elevated levels may contribute to fat being more easily deposited in the walls of blood vessels, promote inflammation in the vessels, and affect the blood’s ability to clot. Over time, this can lead to atherosclerosis, meaning that the blood vessels become narrower and stiffer.
How common is elevated Lp(a)?
Approximately 20 percent of the population has levels considered elevated. Many people are unaware of this because the test is not included in routine cholesterol screenings.
Does high Lp(a) cause any symptoms?
An elevated level cannot be felt in the body and causes no direct symptoms. Problems typically arise only once the blood vessels are affected, potentially resulting in heart attack, stroke, or angina, which involves chest pain during physical exertion. Because the condition is silent, even individuals with a healthy lifestyle and normal cholesterol levels may carry an increased risk without knowing it.
Why might it be wise to test Lp(a)?
Standard lipid panels often measure LDL, HDL, and triglycerides, but not Lp(a). As a result, an important piece of the risk assessment may be missing. By adding a Lipoprotein (a) test, you can gain a more complete picture of your personal risk profile. Measuring Lp(a) may be particularly relevant if there is a family history of cardiovascular disease, if you have experienced heart problems at a younger age, or if disease has occurred without a clear explanation from traditional risk factors. Since the value remains stable throughout life, the test usually only needs to be taken once.
What does an elevated value mean?
A high Lp(a) level does not mean that you will definitely become ill, but it does indicate an increased likelihood of atherosclerosis and cardiovascular disease. Risk is always assessed together with other factors such as blood pressure, blood sugar, smoking, LDL cholesterol, and heredity. Knowing whether you have an elevated level makes it possible to be especially diligent in treating and monitoring other modifiable risk factors.
When should you contact healthcare services?
You can discuss testing with your healthcare provider if you have close relatives who experienced a heart attack or stroke at an early age, if you have had cardiovascular disease without a clear cause, or if you want a more in-depth risk assessment. Seek emergency care if you experience symptoms such as sudden and persistent chest pain, shortness of breath, pressure over the chest, severe headache, difficulty speaking, or weakness in the face, arm, or leg.
How is the diagnosis made?
Lp(a) is measured through a standard blood test. No special preparation is required. The results are interpreted by a physician in relation to your overall health and other risk factors.
Treatment and self-care
Currently, there is no widely used treatment that specifically lowers Lp(a) levels. Research is ongoing into new medications that directly target this blood lipid particle. Therefore, treatment focuses on reducing the overall risk of cardiovascular disease. This may involve lowering LDL cholesterol with medication if needed, treating high blood pressure or diabetes, and providing support for smoking cessation. Regular physical activity, a balanced diet, and maintaining a healthy weight are important components, even though they do not directly affect Lp(a) levels.
Preventive measures
Since Lp(a) is hereditary, it is not possible to prevent having high levels. However, the risk of secondary diseases can be reduced by taking care of your overall heart health and following medical recommendations if other risk factors are identified.