Lp(a), also known as lipoprotein(a) and pronounced “lipoprotein little a” or “L-P little a”, is a cholesterol-like substance produced in the liver and found in the blood. It is made up of two smaller lipoproteins joined together.
Everyone has some Lp(a) in their body – but when levels are too high, it can be harmful. Elevated Lp(a) contributes to inflammation in the inner walls of the arteries, which promotes the buildup of atherosclerotic plaques — made of fats, cholesterol, calcium, and other substances — that can partially block blood flow. Lp(a) also increases the risk that the plaques may rupture, causing a blood clot to form that can fully block the artery. In addition, Lp(a) may interfere with the body’s natural ability to break down blood clots, making clots harder to dissolve. Together, these effects significantly raise the risk of heart attack, ischemic stroke, or peripheral artery disease.
The Lp(a) levels are inherited from one or both parents and can vary widely from person to person and across different populations.
High levels of Lp(a) can double or triple the risk of cardiovascular disease.
The risk is even higher in people living with diabetes.
High Lp(a) levels increase the risk of developing a range of cardiovascular problems, even when other cholesterol numbers are normal.
These may include:
Buildup of fatty deposits in the artery walls
Caused by blockages in the coronary arteries
Often due to blockages in the neck arteries supplying the brain
Reduced blood flow in the extremities - most often the legs - due to blocked arteries
Lp(a) can interfere with the body’s ability to break down clots
While the genes are the main factor in determining Lp(a) levels, certain health conditions have been associated with higher Lp(a) levels in some people.
These include:
Such as low estrogen
Such as rheumatoid arthritis or infections
An underactive thyroid
Unlike other types of cholesterol, Lp(a) is not significantly influenced by diet or lifestyle changes. This makes it especially important to be aware of your level – particularly if you have a family history of certain cardiovascular conditions such as premature atherosclerotic cardiovascular disease or familial hypercholesterolemia.
High Lp(a) levels are mostly determined by genetics and usually stay stable throughout adult life, therefore you only need to check it once in your lifetime.
Lp(a) is not included in routine cholesterol checks — but a simple blood test can measure it.
If your levels are in the intermediate or high-risk category, it is important to talk to your healthcare provider. They can assess your overall cardiovascular risk and help you explore ways to manage it.
While there is currently no approved treatment to specifically lower Lp(a), there are important steps you can take to reduce your overall risk of cardiovascular disease:
While lifestyle changes cannot reduce Lp(a) levels, making heart-healthy choices can go a long way in lowering your overall risk of cardiovascular disease and improving your well-being and longevity. These include: engaging in regular physical activity, eating nutritious foods, not smoking, limiting alcohol use, reducing stress, maintaining a healthy weight and managing other risk factors (especially LDL – bad – cholesterol).
Consult with a healthcare provider to assess your overall cardiovascular risk and develop a personalized plan, especially if you have elevated Lp(a) levels or a family history of heart disease.
There is currently no approved treatment specifically to lower high Lp(a) levels, but this is an active area of research. The field is rapidly evolving, with new therapies and clinical trials on the horizon. Ask your healthcare provider to keep you informed about emerging treatment options and whether they may be suitable for you in the future.
Many people with elevated Lp(a) have no symptoms, which is why testing can be an important step in understanding your heart health. Consider talking to your healthcare provider about an Lp(a) test if you have:
