Lp(a): The New Cholesterol Number

Cholesterol: The Good and the Bad

Cholesterol is chemical your body needs to build cells and produce hormones. It travels through the bloodstream attached to particles called lipoproteins.

One important type is Low-Density Lipoprotein (LDL) - often called the “bad cholesterol.” LDL particles contain a protein called Apolipoprotein B (ApoB), which helps them bind to cells throughout the body.

For decades, LDL has been considered harmful because it can deposit cholesterol into artery walls, leading to plaque buildup. Over time, this increases the risk of blood clots, heart attack, stroke, and other cardiovascular diseases.

A New Kid on the Block: Lp(a)

Another important “bad actor” is Lipoprotein(a), also known as Lp(a).

Like LDL, Lp(a) carries cholesterol through the bloodstream. Like LDL, it contains an additional protein called apolipoprotein(a), which facilitates plaque formation and blood clotting.

In simple terms, Lp(a) is LDL on steroids.

Key Facts About Lp(a)

• About 1 in 5 people have elevated Lp(a).

• More than 90% of your Lp(a) level is determined by genetics.

• High Lp(a) is linked to a higher risk of heart attack, stroke, and aortic valve stenosis.

Why Testing Matters

Routine cholesterol panels often do not include Lp(a). That means someone can have a normal LDL cholesterol level but still carry increased cardiovascular risk because of elevated Lp(a). Many experts now recommend that adults have Lp(a) measured at least once in their lifetime, especially if they have other risk factors or a family history of early heart disease.

Why Lp(a) Is Different

Unlike LDL cholesterol, Lp(a) is largely inherited and is not greatly changed by diet, exercise, or weight loss. As a result, even people with healthy habits can have high Lp(a), which is why testing is important.

Who Should Get Tested

Lp(a) testing may be especially helpful if:

• You have a personal or family history of early heart disease or stroke.

• You have familial hypercholesterolemia, an inherited form of high cholesterol.

• You want a more complete picture of your cardiovascular risk.

Treatment

Currently, there is no medication to lower Lp(a), although several promising treatments are in the pipeline. In the meantime, cardiologists recommend aggressively controlling other cardiovascular risk factors, especially LDL cholesterol. Many specialists aim for an LDL level below 55 mg/dL in higher-risk patients.

It is also important to:

• Keep blood pressure under control

• Manage blood sugar

• Avoid smoking

• Stay physically active

Talk to Your Doctor

Ask your doctor (or call Careborne) to order the Lp(a) test. It is a simple blood test, and for many adults it only needs to be done once in a lifetime. Knowing your Lp(a) level can help you and your doctor make a more informed plan to protect your long-term heart health.