Lipoprotein(a) — Lp(a)
Lipoprotein(a) — Lp(a) — is a genetically determined LDL-like particle that strongly increases cardiovascular and stroke risk. About 20% of people have high Lp(a). Diet and exercise have minimal effect; the value is essentially fixed for life.
Normal Range
Optimal: <30 mg/dL (<75 nmol/L); High: >50 mg/dL (>125 nmol/L)
Reference ranges may vary slightly between laboratories. Always interpret your result in context with your doctor.
Why is Lp(a) measured?
Lp(a) should be measured at least once in adulthood to identify hidden cardiovascular risk. It is especially important in people with a family history of early heart disease, recurrent cardiovascular events despite normal LDL, or unexplained calcific aortic stenosis.
High Lp(a) means…
High Lp(a) doubles or triples the lifetime risk of heart attack, stroke, and aortic stenosis. Because it does not respond to most medications or lifestyle, knowing it is high directs more aggressive control of all other risk factors (especially LDL).
Low Lp(a) means…
Low Lp(a) is normal and has no clinical concern.
Symptoms associated with abnormal Lp(a)
When Lp(a) is high:
- No direct symptoms; reflected in cardiovascular events at younger ages
When Lp(a) is low:
- No symptoms
How to improve your Lp(a)
- If Lp(a) is high, focus on aggressive control of every other modifiable risk factor: LDL, blood pressure, smoking, diabetes.
- Test once in adulthood; the value is essentially constant for life.
- Inform first-degree relatives — they have a 50% chance of also being high.
- New therapies (RNA-based) targeting Lp(a) are in late-stage trials and may be available in 2026–2027.
Frequently asked questions about Lp(a)
Can I lower Lp(a)?
Diet and exercise barely affect Lp(a). PCSK9 inhibitors and aspirin can lower it modestly. RNA-based therapies (pelacarsen, olpasiran) lower Lp(a) by 80–90% and are in phase 3 trials.
How often should Lp(a) be tested?
Once. Lp(a) is genetically determined and remains stable across life. A single measurement in adulthood is sufficient unless you start a Lp(a)-targeted therapy.
Medical Sources
This page is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider about your individual results.