Lipoprotein(a) — Lp(a)
An inherited cholesterol particle that raises heart attack and stroke risk. Your level is set mostly by your genes - so one test usually tells you for life.
TypeBlood biomarker
HowStandard blood draw. No fasting needed.
How oftenOnce in adulthood for most people.
BeforeNo special preparation.
WhoEvery adult at least once - especially with early heart disease or stroke in the family.
Why Lp(a) matters - even when your cholesterol looks normal
Lp(a) is an LDL-like particle with an extra “sticky” protein attached. Like LDL, it carries cholesterol into artery walls - but it also makes blood more likely to clot and heart valves more likely to stiffen. How much you have is set mostly by the genes you inherited.
Set by your genes
“Can I change it?”
Mostly inherited. Diet and exercise barely move it - so one test usually covers you for life.
Test once
Hidden from routine tests
“Wasn’t it in my cholesterol test?”
No. A standard cholesterol panel doesn’t include it. You only find out if you ask.
Ask for it
Adds to everything else
“Why does it matter if I’m healthy?”
A high Lp(a) makes your other risks count for more - cholesterol, blood pressure, blood sugar, smoking.
Raises the stakes
Same cholesterol. Different inherited risk.
Regular LDL particleLp(a) particle
Person A
LDL cholesterolNormal
ApoBNormal
Lp(a)Normal
Person B
LDL cholesterolNormal
ApoBNormal
Lp(a)High
Some of B’s particles are Lp(a) - each more harmful than a regular one. This is often the missing piece when heart disease appears “out of nowhere” in someone fit with normal cholesterol.
If your Lp(a) is high
You can’t change your Lp(a) much today - but you can change what it adds up to.
01
Lower ApoB and LDL further
The most proven step. Many providers aim lower when Lp(a) is high.
02
Tighten everything else
Blood pressure, blood sugar, not smoking, fitness - each matters more for you.
03
Consider a calcium score
From about 40, it shows whether plaque has actually formed.
04
Tell your family
Parents, siblings and children have a 1 in 2 chance of sharing it.
Medicines that specifically lower Lp(a) are in late-stage trials.
Is it right for you?
Worth considering if…
- You’ve never had it checked.
- Heart attack, stroke or aortic valve narrowing runs in your family - especially at a young age.
- You had heart disease despite normal cholesterol.
- A relative has been told their Lp(a) is high.
A better option if…
- You’ve already had it tested - it rarely changes, so repeating adds little.
- You want your current particle burden - that’s ApoB.
- You want to know if plaque has formed - a calcium score shows that.
How it’s measured
Lab blood draw
Ask for “lipoprotein(a)”. Often not included unless you ask.
Reported in nmol/L or mg/dL
The two units can’t be converted exactly - compare like with like.
The full picture
What is it?
Lp(a) is an LDL-like particle with an extra protein attached. It promotes plaque, clotting and valve calcification.
What type of test is it?
A blood biomarker, largely determined by genetics.
What does it measure?
The concentration of Lp(a) particles in your blood.
Why might someone consider it?
About 1 in 5 people have high Lp(a), it isn’t shown on a standard cholesterol panel, and diet and exercise barely change it - so the only way to know is to test.
Who is it most relevant for?
Every adult once, and especially people with a family or personal history of early heart disease or stroke.
How is it performed?
A routine blood draw - it can be added to your next lipid panel.
How often might it be considered?
Usually once in a lifetime. It may be repeated in special situations, such as during treatment trials.
What can the result help you understand?
Whether you carry an inherited risk that makes other risk factors - like ApoB and blood pressure - more important to control.
What are its limitations?
There’s no approved medication that specifically lowers it yet (trials are underway), units vary between labs, and it’s one factor among many.
What should it be viewed with?
ApoB, LDL, family history, blood pressure and - when appropriate - a calcium score. A high result is also a reason for close relatives to test.
Where to get it
Through your provider
The simplest route - often covered when there’s a clear reason.
Lab services
e.g. Quest Diagnostics, Labcorp.
Direct-to-consumer panels
e.g. Function Health, InsideTracker.
Names are examples only, not endorsements. Your provider can often order the same test - and help interpret it.
Connected to
Questions to ask your provider
- Has my Lp(a) ever been measured?
- If it’s high, what else should I focus on lowering?
- Should my parents, siblings or children be tested?
- Would a calcium score help decide my treatment?
Ziva Health
One test is a snapshot. Ziva shows the whole story.
Ziva brings your lab results, wearables and daily readings together - and Isabella tells you what’s changing and what to ask your provider next.
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Being listed doesn’t mean everyone needs this test. Educational only — not medical advice. Results should be interpreted with a qualified clinician. ← Back to Know What to Test