• About Lp(a)
• Causes
• Testing
• What high Lp(a) means
• Normal ranges
• Can levels reduce?
• Risk reduction
• Summary

Lipoprotein(a), or Lp(a), is a protein that transports cholesterol in the blood. High levels of Lp(a) in the blood can increase the likelihood of plaques or blood clots forming in the arteries.

As a result of this effect, Lp(a) can increase the risk of cardiovascular disease. Taking steps to control cholesterol levels can help reduce this risk.

A doctor can carry out a blood test to check a person’s Lp(a) levels if they suspect that they may be high.

In this article, we look at what determines Lp(a) levels, what different test results might mean, and what steps a person can take to reduce their risk of cardiovascular disease.

What is lipoprotein(a)?

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Lipoproteins are a type of protein that transports cholesterol, a fatty substance, in the blood.

There are two main types of lipoprotein: high-density lipoprotein (HDL) cholesterol, which people may refer to as good cholesterol, and low-density lipoprotein (LDL), or bad, cholesterol.

Read on to learn more about HDL vs. LDL.

The body needs a certain amount of cholesterol to function well. Cholesterol plays various rolesTrusted Source in the body and is necessary for the maintenance of cell structure and the production of steroid hormones. High levels of HDL cholesterol may even help decreaseTrusted Source the risk of cardiovascular disease.

However, high levels of LDL cholesterol can cause atherosclerosis, which is a buildup of fatty deposits in the blood vessels that can increase the risk of cardiovascular disease.

Lp(a) is a risk factor for developing cardiovascular disease. Research shows that Lp(a) can cause LDL cholesterol to form plaques on blood vessel walls, narrowing or blocking blood vessels and the hardening of arteries, which increases the risk of heart disease and stroke.

Also, apolipoprotein(a), a protein that makes up part of Lp(a), can prevent enzymes from dissolving blood clots, so it may increase the risk of clots forming in the arteries.

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What causes high Lp(a) levels?

Genetic factors seem to determine whether people have high Lp(a) levels. The American College of Cardiology (ACC) guidelines suggest that Lp(a) levels are genetic, with little to no influence from environmental or lifestyle factors.

However, there is some evidence that diet and lifestyle may also affect them. More studies are necessary to understand whether diet and lifestyle habits may contribute to high Lp(a) levels.

Research suggests that about 20% of the world’s population have elevated Lp(a) levels.

How do doctors test for it?

An Lp(a) test is not a routine test. However, doctors may test a person’s Lp(a) levels if their family medical history is unknown or they have:

• a family history of early cardiovascular disease
• cardiovascular disease but only slightly raised cholesterol or lipid levels
• an inherited higher risk of high cholesterol levels

The doctor will perform this test by taking a sample of blood from a vein in the individual’s arm.

Preparing for an Lp(a) test is not necessary. However, if the doctor also plans to perform a lipid panel test, which checks for cholesterol and triglyceride levels in the blood, they may ask the person to fast for 9 to 12 hours beforehand and only drink water.

Healthcare professionals will advise a person on how to prepare for their blood test.

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What does high Lp(a) mean?

High Lp(a) levels may indicate an increased risk of cardiovascular disease. People can receive normal lipid panel test results and still have elevated Lp(a) levels.

Some health conditions may cause high Lp(a) levels. These include:

• hypothyroidism, an underactive thyroid
• kidney disease
• nephrotic syndrome, a kidney disorder

In some cases, low estrogen levels may cause Lp(a) levels to increase. A doctor may test people going through menopause to check for a risk of cardiovascular disease, although this is rare.

Low or undetected levels of Lp(a) do not cause any health problems.

Normal ranges

According to the American College of Cardiology, guidelines vary regarding cutoff points for high Lp(a) levels. High Lp(a) level markers may also vary among individuals, depending on risk factors and additional health conditions.

Currently, guidelines have a consensus of 50 being the cutoff point for high Lp(a) levels. An ACC report notes that guidelines are as follows:

• more or equal than 50 milligrams per deciliter (mg/dL), or more or equal than 125 nanomoles per liter (nmol/L) is an accepted target in American College of Cardiology/American Heart Association (ACC/AHA) guidelines
• more or equal than 50 mg/dL (or more or equal than 100 nmol/L) is an accepted target in the Canadian Cardiovascular Society (CCS) guidelines
• less than 30 mg/dL (or less than 75 nmol/L) is considered normal, 30 to 50 mg/dL (or 50 to 125 nmol/L) intermediate, and more than 50 mg/dL (or more than 125 nmol/L) abnormal in the European Atherosclerotic Society (EAS) consensus statement
• more than 50 mg/dL (or more than 100 nmol/L) is accepted as a risk-enhancing cutoff in the National Lipid Association (NLA) scientific statement

Some experts suggest that high Lp(a) levels are those measuring 50 milligrams per deciliter (mg/dl) or higherTrusted Source, whereas other guidelines suggest a slightly lower threshold.

Studies suggest that adults have an increased risk of heart attack and coronary heart disease if they have Lp(a) levels above 30 mg/dl. Furthermore, they may have an increased risk of ischemic stroke if they have Lp(a) levels above 50 mg/dl.

Healthcare professionals consider low or undetected Lp(a) levels to be healthy. Normal Lp(a) levels are under 30 mg/dl. Some people may even have undetectable levels of Lp(a).

A person can consult their doctor to understand their test results. Some laboratories may use different ranges or measurements.

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Is it possible to reduce Lp(a)?

Genetic factors determine Lp(a) levels. As a result, it can be difficult to alter them, and there are currently no specific treatments to do so.

Medications that inhibit PCSK9 may reduceTrusted Source Lp(a) levels, but further research is necessary to confirm this effect before doctors can recommend drugs for this use.

Lipoprotein apheresis is a procedure similar to dialysis. A machine separates cholesterol from blood plasma and removes the Lp(a) and LDL cholesterol from the blood.

People will require weekly or biweekly procedures to keep removing the cholesterol from the blood.

A limited number of medical centers in the United States and Canada offer lipoprotein apheresis. Alternatively, people can ask their doctor about any clinical trials that are currently researching further treatments for lowering Lp(a). For example, this may include therapies that specifically target Lp(a).

As genetic factors largely determine Lp(a) levels, these are not likelyTrusted Source to change throughout a person’s lifetime.

In the meantime, people can focus on reducing controllable risk factors for cardiovascular disease. Focusing on lowering LDL cholesterol levels may be particularly beneficial.

Reducing the risk of cardiovascular disease

Dietary and lifestyle changes can reduce LDL cholesterol, which can help lower the risk of cardiovascular disease.

People can take steps to improve their health and lower their risk. These includeTrusted Source:

• Adopting a healthy diet to support the heart: A healthy diet includes omega-3 oils, nuts, olive oil and some other vegetable oils, whole grains, fruits, and vegetables. It should also exclude or limit saturated and trans fats, such as those in fatty meat, dairy, and processed foods.
• Exercising regularly: Staying physically active can lower LDL cholesterol and raise HDL cholesterol.
• Managing body weight: If people have excess weight, losing 3–5% of their body weight is enough to lower LDL and raise HDL cholesterol.
• Minimizing stress: Chronic stress may increase LDL cholesterol.
• Quitting smoking: People who smoke can seek help to stop smoking to support heart health.
• Getting better quality sleep: The Centers for Disease Control and Prevention (CDC) recommend that people aim to get 7 to 9 hoursTrusted Source of sleep each night to help the heart and blood vessels recover and repair.
• Limiting alcohol: People can limit their alcohol intake to increase heart health. Anyone who needs help to stop drinking can seek support from medical and mental healthcare professionals and support groups.

Summary

Genetic factors primarily determine Lp(a) levels, so these generally remain the same throughout a person’s life. High levels of Lp(a) can increase the risk of cardiovascular disease.

Although there is currently no specific treatment to lower Lp(a) levels, taking steps to lower LDL cholesterol can help reduce the risk of cardiovascular disease.

Last medically reviewed on February 14, 2025