Lipoprotein(a), or Lp(a), is a genetic form of cholesterol that cannot be changed by lifestyle or medication, but it could be the missing piece in unexplained heart attacks.
Whenever we talk about our risk of developing heart disease, it is typically the usual suspects that are brought up, like cholesterol, blood pressure, and a not-so-commendable lifestyle. However, there’s another, less widely known factor that can have a significant influence on your cardiovascular risk: lipoprotein(a).
Often shortened to Lp(a), it’s something doctors and researchers have been paying closer attention to in recent years, because of the quiet manner in which it increases this risk. Basically, you could be eating well, working out regularly, and abstaining from smoking and alcohol, yet still have a greater likelihood of getting a heart attack.
So let’s break down what it is, and what you can do if your level of Lp(a) happens to be higher than normal.
What Is Lipoprotein(a)?
Lp(a) is a more complex form of low-density lipoprotein (LDL) cholesterol, what we all understand as “bad” cholesterol. Similarly to LDL cholesterol, it can accumulate along the walls of our arteries, promoting a condition known as atherosclerosis.
“Atherosclerosis occurs when cholesterol, fat and other substances build up in the arteries over the years and form hard structures known as plaque,” explained Dr Tan Hong Chang, a Senior Consultant in the Department of Endocrinology at Singapore General Hospital, in HealthXchange.
“When this happens, blood flow to vital organs could be restricted. This plaque can also burst, causing a blood clot.”
As atherosclerosis has no symptoms, you may only realise you have a problem when your arteries become too narrow and clogged up.
“When a blood clot completely blocks the artery or even breaks apart, it can cause a heart attack or stroke which can be debilitating or even fatal.”
About Lp(a)
Part of the reason why Lp(a) is so intriguing?
The fact that its levels depend on your genes.
Unlike LDL, which can change depending on your lifestyle, Lp(a) is a component determined the moment you were born. If your Lp(a) levels are high, it’s an unfortunate inheritance you received from your parents.
So you’ll want to give some thought to testing it in the case of the following factors:
- You have a family history of heart diseases, particularly if it developed prematurely.
- You’ve already had a heart attack or stroke, despite having managed risk factors like typical cholesterol levels.
- A family member has been diagnosed with elevated Lp(a).
How to Test for Lipoprotein(a)
Considering that our Lp(a) level stays the same throughout our life, it’s been recommended by the European Atherosclerosis Society that we check it at least one time, especially if we’re at high risk.
However, although having a high Lp(a) can be immensely impactful on the health of our heart, it often goes unrecognised – and it could be because this particular lipoprotein isn’t tested as part of a common lipid panel.
So when you’re going for a blood test, be sure to specifically request a check on your Lp(a) level too.
A normal level of Lp(a) is below 30 mg/dL, or below 75 nmol/L, depending on the preferred unit of measurement of the lab. But if it’s elevated, the numbers you’re looking at are 50 mg/dL and above, or 125 nmol/L and above.
If your Lp(a) levels are abnormal, treatments prescribed may include PCSK9 inhibitors, a type of cholesterol-reducing medicine, or lipoprotein apheresis, a non-surgical procedure for removing excess Lp(a).
Can We Lower Lp(a) Naturally?
The unfortunate answer: no.
A balanced diet and a daily exercise regime don’t reduce it, and most cholesterol medications aren’t even very effective on high Lp(a).
Regardless, while you can’t lower Lp(a) directly, there’s still a lot you can do to reduce your risk of heart diseases in general.
Why a Healthy Lifestyle Still Matters
Sure, a healthy lifestyle has no effect on your Lp(a), but it does make a difference in your overall heart risk.
Beyond supporting your cardiovascular health in general, living well can also prevent us from developing other conditions both physical and mental, including metabolic disorders, dementia, and cancer.
Proactive ways to manage your wellbeing include:
- Adopting a heart-healthy diet rich with omega-3 oils, nuts, whole grains, fruits, and vegetables.
- Exercising regularly to reduce LDL cholesterol, and even raise HDL, or “good”, cholesterol.
- Maintaining a healthy body weight, which can help rebalance your cholesterol levels.
- Getting good quality sleep of 7 to 9 hours a night, to support recovery and repair of the heart and arteries.
- Limiting your smoking and alcohol intake.
- Managing your stress, as it can affect your cholesterol levels and heart.
And don’t wait for a problem to show up. Get tested early, and learn more from your doctor on how you can protect your heart. Knowledge is power, and can go a long way in ensuring you live a stronger, healthier life.
Read more:
- Heart Diseases: What Are The Different Types Affecting People?
- Managing High Cholesterol: The Importance of Medication Adherence over Dietary Changes
External References
- Bailey, E. (2023, June 13). Form of ‘bad cholesterol’ increases risk of heart disease — what to know about lipoprotein(a). Medical News Today. Retrieved from: https://www.medicalnewstoday.com/articles/form-of-bad-cholesterol-increases-risk-of-heart-disease-what-to-know-about-lipoproteina
- Cleveland Clinic. (2023, August 21). Lipoprotein (a). Retrieved from: https://my.clevelandclinic.org/health/articles/25226-lipoprotein-a
- Corliss, J. (2025, March 1). Lipoprotein(a): An update on testing and treatment. Harvard Health Publishing. Retrieved from: https://www.health.harvard.edu/heart-health/lipoproteina-an-update-on-testing-and-treatment
- Kronenberg, F., Mora, S., & Stroes, E. S. G. (2022). Consensus and guidelines on lipoprotein(a) – seeing the forest through the trees. Current Opinion in Lipidology, 33(6), 342–352. Retrieved from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9643632/
- Lim, J. (n.d.). Young, Slim… and Hiding High Cholesterol? HealthXchange. Retrieved from: https://www.healthxchange.sg/how-to-manage/high-blood-cholesterol-and-hyperlipidaemia/young-slim-hiding-high-cholesterol
- National Heart, Lung, and Blood Institute. (2024, January 17). Lipoprotein(a): What to know about elevated levels. Retrieved from: https://www.nhlbi.nih.gov/news/2024/lipoproteina-what-know-about-elevated-levels
- Sissons, B. (2025, February 26). What to know about lipoprotein(a). Medical News Today. Retrieved from: https://www.medicalnewstoday.com/articles/lipoprotein-a-what-it-is-test-results-and-what-they-mean
