Lipoprotein(a) testing

What is lipoprotein(a)?

Lipoprotein(a), or Lp(a) for short, is a cholesterol-carrying particle in the blood. A raised level is a significant risk factor for cardiovascular disease. High Lp(a) can promote hardening of the arteries (atherosclerosis), increasing the likelihood of heart attack, stroke and other cardiovascular diseases. A raised Lp(a) level usually causes no symptoms, so a blood test is needed to detect it.

What causes a raised Lp(a) level?

Lp(a) levels are determined mainly by inherited, genetic factors, so high levels often run in families. Unlike ordinary cholesterol, Lp(a) levels are usually only slightly affected by diet, exercise or lifestyle changes. The level is mostly established at a young age and stays relatively stable throughout life.

What treatments are available?

Treatment of raised Lp(a) currently focuses on reducing cardiovascular risk factors. This includes getting LDL cholesterol to the right level, treating high blood pressure and diabetes, and maintaining a healthy lifestyle. Some cholesterol-lowering medicines can also reduce Lp(a). In addition, new medicines designed specifically to lower Lp(a) are being developed and tested in clinical trials.

What risks does a raised Lp(a) level carry?

High Lp(a) can contribute to deposits forming in the artery walls and to atherosclerosis. This can increase the risk of coronary heart disease, heart attack, ischaemic stroke and narrowing of the aortic valve (aortic stenosis). The risk can be particularly high in people with other risk factors, such as high LDL cholesterol, high blood pressure or diabetes.

How is a raised Lp(a) level diagnosed?

Lp(a) can be measured with a simple blood test. Because it is determined mainly by genetics, measuring it at least once in adulthood is generally recommended. The test can be particularly important for people with a family history of heart attack or other cardiovascular disease at a young age. Other risk factors should also be considered when interpreting the result.

Why are clinical trials important?

Lipoprotein(a) is a key area of cardiovascular research. Clinical trials are studying new medicines that can lower Lp(a) levels in a targeted and substantial way. The research aims to evaluate the efficacy and safety of these medicines and to establish whether lowering Lp(a) can reduce heart attacks, strokes and other cardiovascular events.