Lp(a) is a cholesterol particle determined by your genes. About 1 in 5 people have elevated levels. It doesn't respond to diet or exercise, yet it's one of the strongest risk factors for early heart attack and stroke. Most people have never been tested.
Why Lp(a) is dangerous
Each Lp(a) particle is up to six times worse than a regular LDL particle. It sticks to artery walls more easily, drives inflammation, and promotes blood clots. Research shows people with high Lp(a) have elevated heart risk even when their LDL, blood pressure, and calcium score look fine.
Your level is set at birth and stays constant your whole life. Diet, exercise, and statins barely move it.
What counts as high
Labs report Lp(a) in two units:
| Level | mg/dL | nmol/L (preferred) |
|---|---|---|
| Normal | < 30 | < 75 |
| Borderline | 30–50 | 75–125 |
| Elevated | > 50 | > 125 |
The higher your number, the higher your lifetime risk. Risk rises steeply above the elevated threshold.
Who should test
Everyone should test once by age 40. Test earlier if you have:
- Family history of heart attack before 55 (men) or 65 (women).
- Personal history of early heart disease.
- Calcium score of zero but you're in a high-risk group.
Since Lp(a) is genetic and stable, you only need to test once in your life.
What to do if your Lp(a) is high
No drug today meaningfully lowers Lp(a). Several are in late-stage trials and may reach the market in the next few years. Until then, the strategy is to control every other risk factor harder:
- Lower LDL below 55 mg/dL (or lower).
- Keep blood pressure under 120/80.
- Don't smoke or vape.
- Treat insulin resistance aggressively.
- Get a coronary CT angiogram to see if plaque is already there.
Think of high Lp(a) as raising the bar on what counts as safe for everything else. More on imaging in our coronary CT angiogram guide.
The bottom line
One test, once in your life, tells you if you have a hidden genetic risk hitting 20% of the population. If it's high, the next steps are clear. If it's low, cross it off the list forever.
Confidence in your heart health
A CT angiogram heart scan that gives you the full picture of your arteries, giving you clarity and the power to act early. Reserve your spot today.