The Hidden Risk
Learn more about Lp(a) — say it “L-P-little-a.”
It’s a heart risk that runs in families, hides from regular tests, and most people have never heard of. Here’s what you need to know.
The Basics
What is Lp(a)?
Lp(a) — lipoprotein (a) — is a tiny particle in your blood, a cousin of the cholesterol you already know about. Everybody has some. The problem is having a lot.
- Your level is set by your genes. You get it from your parents, the same way you get your height or your eye color.
- It stays about the same your whole life. That’s why one test, once, is usually all you need.
- Diet and exercise don’t change it. You can do everything right and still have a high number. It is not your fault.
- It’s common. About 1 in 5 people have high Lp(a) — and levels tend to run higher in people of African descent.
Why it’s called “hidden”
High Lp(a) has no symptoms. You can’t feel it, and your regular cholesterol test doesn’t look for it.
The only way to know your number is a simple blood test — and you have to ask for it by name.
Why It Matters
What a high number can mean.
When Lp(a) is high, it can make blood more likely to clot and arteries more likely to get irritated and clogged. Over time, that raises the risk of:
Heart attack — blocked blood flow to the heart.
Stroke — blocked blood flow to the brain.
Artery trouble — in the heart’s valves or in the legs (called PAD).
What counts as high? Doctors generally consider Lp(a) high at 50 mg/dL (or 125 nmol/L) and above — the test report may use either unit. Don’t worry about memorizing that. Your doctor will explain your number and what it means for you.
Common Questions
You asked. Here are honest answers.
Who should get tested?
Heart doctors now say every adult should have their Lp(a) checked at least once in their life. It matters even more if heart disease or stroke runs in your family, or if a relative had heart trouble young.
What does the test involve?
It’s a regular blood draw — the same kind you get at a checkup. Your doctor can usually add it to blood work you’re already getting. Just ask: “Can you add an Lp(a) test to my blood work?”
What if my number is high?
First: a high number is not a diagnosis, and it’s not a sentence. It’s information — and information is power.
Diet and exercise won’t lower Lp(a) itself, but they powerfully protect your heart in every other way. Your doctor will help you work on the things you can control: blood pressure, cholesterol, blood sugar, smoking, movement, and sleep. Together, that adds real protection.
Should my family get tested too?
Yes — this is the big one. Because Lp(a) is inherited, if your number is high, your parents, brothers, sisters, and children may share the same risk. Telling them, and encouraging them to get their one-time test, is one of the most loving things you can do. Our family conversation guide can help.
Why haven’t I heard of this before?
You’re not alone — most people haven’t. Lp(a) isn’t part of the routine cholesterol panel, so it often never comes up. That’s exactly why we’re talking about it: the people who need this test most are the people least likely to have been told about it.
One Sentence Can Change Everything
“I’d like to get my Lp(a) checked.”
Say it at your next appointment. One test, once in your life. Make the request. Get the test.