High Lipoprotein(a) Explained: What You Need to Know about This Hidden, Emerging Indicator for Heart Disease

You have your father’s eyes. Your mother’s smile. Your grandpa’s sense of humor. Some family traits are plain to see. Others may linger beneath the surface, unnoticed until a doctor uncovers them. 

Genetics can impact your heart health in ways you might not realize⁴. It is estimated that nearly half of all adults aged 20 years or older have heart disease⁵. But learning about, monitoring, and identifying heart disease risk factors early may help you better understand your overall heart health⁶.

Many things can impact heart disease risk. Some of these factors—like diet and exercise—are within your control. Others, like genetics, which are passed down by your family, are not. An example is high lipoprotein(a), also known as Lp(a) or “L-p-little a.” This is an inherited condition that can independently increase the risk of heart disease^1,2,3,7.

It is estimated that about 20% of the population—or 1 in 5 people worldwide—have high Lp(a)⁴. It’s even more common in those who’ve experienced heart attacks or strokes at an early age (before 55 for men or 65 for women)^6,8,9. Despite its prevalence, unfortunately Lp(a) levels are often not measured^11,12. Knowing your Lp(a) level may help you and your doctor better understand and manage your overall heart health⁶.

Read on to learn more about high Lp(a) and how it may impact you and possibly your family. 

1. What Lp(a) Is and Why it Matters

Everyone naturally has Lp(a) in their blood, the main job of which is to help transport fats through the bloodstream¹³. The risk comes when a person has a high level of Lp(a), which can increase the risk of blood clots and inflammation and can place a person at risk for heart disease^1,14,15.

2. What Causes a High Level of Lp(a) 

An Lp(a) level is approximately 90% genetically determined and set by around age 5, staying mostly the same for life. Lifestyle typically does not impact a person’s Lp(a) level, meaning that a healthy, active person can have high Lp(a)⁸. An Lp(a) level greater than or equal to 125 nmol/L or 50 mg/dL indicates a high level⁶.

3. How High Lp(a) Contributes to Heart Disease

An Lp(a) level greater than or equal to 125 nmol/L (50 mg/dL) is considered high risk for heart disease⁶. Even if your "bad” cholesterol levels are normal, a high level of Lp(a) can still put your heart health at risk because it is an independent risk factor^1,2,3.

4. Who Is More Likely to Have High Lp(a) – and How Common It Is

Approximately 1 in 5 people worldwide have a high Lp(a) level⁴. People with early heart disease (ages less than 55 years in men, 65 years in women) and those who have a family history of early heart disease should talk to their doctor about getting tested for high Lp(a)^6,8,9.

5. Why You Should Consider Getting Your Lp(a) Level Tested

Your Lp(a) level can be measured with a simple blood test; no genetic testing is needed¹. According to the National Lipid Association, all adults should get their Lp(a) levels tested at least once in a lifetime⁶. However, it is important for people who have had a premature heart attack or stroke (ages less than 55 years in men, 65 years in women) to get their Lp(a) levels tested⁸. 

Consider talking to your doctor about getting tested for high Lp(a) and for more information and next steps.

6. What to Do if Your Lp(a) Level Comes Back High (greater than or equal to 125 nmol/L or 50 mg/dL)

If you uncover a high level of Lp(a), you can create a plan with your doctor to help manage your overall heart health. This could include:

• Eating a heart-healthy diet ^6,10,16
• Exercising regularly ^6,10,16
• Avoiding smoking ^6,10,16
• Getting a good night's sleep (at least seven hours per night) ^6,10,16
• Maintaining a healthy body weight ^6,10,16
• Managing other heart disease risk factors, including high blood pressure and cholesterol⁶

These measures may not affect your Lp(a) level, but they can help address other risks to heart health^7,8.

Additionally, talk to your family. Because high Lp(a) could be passed down, your loved ones might also be at risk. Have a conversation about high Lp(a) and encourage them to talk to their doctor about getting tested, too^1,7. 

7.  Treatment Options for High Lp(a)

There are no FDA-approved medicines to decrease high Lp(a). Therapies are under investigation. You should talk to your doctor about ways to manage your overall heart health¹⁷. 

It’s time to prioritize your heart health. If you have a personal or family history of early heart disease, talk to your doctor about Lp(a) testing today. You can also learn more about high Lp(a) at WhatisLpa.com.