What Is Lipoprotein(a)?

Lipoprotein(a), often written Lp(a), is a type of lipoprotein particle in your blood. Like LDL (“bad cholesterol”), it carries fats around the body — but Lp(a) has an extra protein called apolipoprotein(a) attached, which makes it more likely to stick to artery walls and contribute to plaque buildup.

High levels of Lp(a) are an independent genetic risk factor for cardiovascular disease, meaning they can raise your risk of heart attack, stroke and other vascular problems even if your standard cholesterol numbers are OK.

Why It Matters

Elevated Lp(a):

• Promotes plaque buildup inside arteries (atherosclerosis).

• Increases blood clot formation.

• Is linked with narrowing of the aortic heart valve (aortic stenosis).

What Are the Symptoms?

High Lp(a) itself does not cause symptoms. It’s typically discovered only through blood testing because it doesn’t produce warning signs like pain, shortness of breath or fatigue until cardiovascular disease has developed.

That’s why measurement is important — it helps identify hidden risk before a heart attack or stroke occurs.

Certain conditions can also raise Lp(a) marginally, including:

• Kidney disease

• Hypothyroidism

• Menopause in women

How Is It Diagnosed?

A simple blood test measures Lp(a) levels, usually once in a lifetime since the result doesn’t fluctuate much over time.

Testing may be recommended if you have:

• A family history of early cardiovascular disease

• Personal or family history of high cholesterol

• Early heart attack or stroke without clear causes

• Familial hypercholesterolemia (an inherited lipid disorder)

Results can be reported in mg/dL or nmol/L, and higher values generally indicate greater risk.

Managing High Lp(a)

There is no universally effective therapy that directly lowers Lp(a) at the moment. However, you can reduce your overall cardiovascular risk by focusing on factors you can control:

Lifestyle & risk management

• Keep LDL (“bad”) cholesterol low

• Quit smoking

• Eat a heart-healthy diet

• Stay physically active

• Maintain a healthy weight

• Control blood pressure and diabetes

Who Should Be Tested?

Consider discussing an Lp(a) test with your clinician if you have:

• A strong family history of early heart disease

• A personal history of unexplained cardiovascular events

• Other cholesterol problems that don’t fully explain your risk

Testing once is usually sufficient because levels remain relatively constant throughout life.

With best wishes,  

Dr Milton Maltz MD, M.Phil