Lp(a) is a genetic form of cholesterol that has gained increasing attention in recent years within the medical community. An elevated Lp(a) level is now recognized as one of the most important, yet often unknown risk factors for cardiovascular disease.

Many people know their cholesterol, blood pressure, and blood sugar levels, but have never heard of Lp(a). Yet this often-overlooked marker can make the difference between a healthy heart and an increased cardiovascular risk.

A high Lp(a) level can cause damage for years without any symptoms. As a result, heart and vascular problems can appear unexpectedly, even in people who live healthily and have normal cholesterol levels.

Why elevated Lp(a) is so dangerous
Lp(a) is not just another type of cholesterol. It actively drives plaque build-up, inflammation, and blood clot formation. This combination makes it a powerful and independent risk factor for cardiovascular disease.

An elevated Lp(a):

• Doubles to quadruples the risk of heart and vascular disease.
• Often occurs in people who otherwise live a healthy lifestyle.
• Is not influenced by diet or exercise.
• May become treatable in the near future thanks to new medications specifically designed to lower Lp(a).

Lp(a) is the part of your cholesterol profile that you cannot control, but you can measure and understand.

The link between Lp(a) and cardiovascular disease

Research shows that people with elevated Lp(a) levels have a higher risk of:

• Heart attacks
• Strokes (TIA or ischemic stroke)
• Arterial plaque build-up (atherosclerosis)
• Aortic valve calcification or narrowing

This is because Lp(a):

• Makes the artery walls “stickier,” allowing cholesterol to accumulate more easily.
• Triggers inflammation that makes plaques unstable.
• Interferes with the breakdown of blood clots, increasing the risk of thrombosis or heart attack.

According to a large European study published in the European Heart Journal (2022), people with the highest Lp(a) levels have up to three times greater risk of developing cardiovascular disease compared to those with low levels.

What is the impact of high Lp(a) on life expectancy
An elevated Lp(a) level can cause heart and vascular diseases to occur five to ten years earlier than average.

A high Lp(a) level does not necessarily lead to illness or a shorter lifespan, but it increases the likelihood that cardiovascular problems will appear earlier in life.

Knowing at a young age that your Lp(a) is elevated allows you to take preventive action. Lowering LDL cholesterol, quitting smoking, and controlling blood pressure and blood sugar can largely offset the extra risk.

Lp(a) does not directly shorten your life, but it can influence the timing of when cardiovascular disease develops.

How common is elevated Lp(a)?
High Lp(a) levels are far more common than most people realize.

Facts at a glance:

• Globally, about 1 in 5 adults have elevated Lp(a) levels (often defined as >125 nmol/L or >50 mg/dL).
• European population studies show that roughly 20% of people in Europe have Lp(a) above 50 mg/dL (~125 nmol/L). link
• If we apply that 20% across Europe’s roughly 750 million people, this implies around 150 million adults in Europe may have high Lp(a) levels.
• People of African descent generally have higher Lp(a) levels than those of European or Asian descent.
• Because Lp(a) is genetic, if one family member has a high level, it’s likely that others do as well.

Why early detection makes a difference
An Lp(a) test is a simple blood test that you usually only need to take once in your life. The value is genetically determined and remains stable from an early age. By measuring your Lp(a) level early, you can take action before any damage to your heart or blood vessels occurs. Many people only discover they have elevated Lp(a) after a heart attack or stroke, even though this could have been prevented with a simple blood test, sometimes even done at home.

Based on your test result, you can:

• See whether your risk of cardiovascular disease is genetically elevated.
• Work with your doctor to decide how to reduce that risk.
• Help your family by encouraging them to get tested as well.

Through a simple blood test — at your GP’s office or at home — you can find out whether your Lp(a) level is elevated. This allows you to identify a genetic cardiovascular risk early and take preventive steps in time.

What can you do if your Lp(a) is elevated?
Although your Lp(a) level itself cannot be influenced by diet or lifestyle, there is much you can do to protect your heart and blood vessels. The goal is to lower your overall cardiovascular risk.

What helps:

• Lower your LDL cholesterol as much as possible. Even if your LDL level is not elevated, lowering it can be beneficial. A lower LDL value helps offset the additional risk caused by Lp(a). Your doctor can determine whether medication such as PCSK9 inhibitors is appropriate for you.
• Keep your blood pressure and blood sugar well controlled. High values put extra strain on your blood vessels.
• Quit smoking and exercise regularly. Both improve circulation and help keep your arteries healthy.
• Eat a heart-healthy diet. Choose plenty of vegetables, whole grains, legumes, fiber, and unsaturated fats such as olive oil, nuts, and oily fish.

In addition, several promising new drugs are currently being developed that can directly lower Lp(a) levels. These therapies are expected to become available within the next few years and may represent a major breakthrough, especially for people with very high levels.

Sources
Scientific sources and medical references. The information on this page about lipoprotein(a), hereditary cardiovascular risk, atherosclerosis, and life expectancy is based on the following peer-reviewed studies and publications:

Vinci P, et al.
Lipoprotein(a) as a Risk Factor for Cardiovascular Diseases.
PubMed, 2023.
Concise summary of evidence demonstrating that elevated Lp(a) is associated with cardiovascular disease independently of LDL-cholesterol.
https://pubmed.ncbi.nlm.nih.gov/37754581/

Lau FD, et al.
Lipoprotein(a) and its Significance in Cardiovascular Disease.
PubMed, 2022.
Demonstrates a strong association between elevated Lp(a) and residual cardiovascular risk despite optimal management of traditional risk factors.
https://pubmed.ncbi.nlm.nih.gov/35583875/

Reyes-Soffer G, et al.
Lipoprotein(a): A Genetically Determined, Causal, and Independent Risk Factor for Atherosclerotic Cardiovascular Disease.
Arteriosclerosis, Thrombosis, and Vascular Biology, 2022.
Comprehensive review providing mechanistic evidence supporting the causal role of Lp(a) in atherosclerotic cardiovascular disease.
https://www.ahajournals.org/doi/10.1161/ATV.0000000000000147

Wong ND, Fan W, Hu X, et al.
Lipoprotein(a) and Long-Term Cardiovascular Risk in a Multi-ethnic Pooled Prospective Cohort.
Journal of the American College of Cardiology, 2024.
Large prospective cohort study confirming the association between elevated Lp(a) levels and long-term ASCVD risk across diverse populations.
https://www.jacc.org/doi/10.1016/j.jacc.2024.02.031

Dhaine S, et al.
Lipoprotein(a) as a Causal Risk Factor for Cardiovascular Disease and Calcific Aortic Valve Stenosis.
Springer, 2025.
Synthesis of epidemiological, genetic, and mechanistic evidence supporting a causal role of Lp(a) in ASCVD and calcific aortic valve disease.
https://link.springer.com/article/10.1007/s12170-025-00760-1

Tasdighi E, et al.
Lp(a): Structure, Genetics, Associated Cardiovascular Risk and Clinical Implications.
PubMed, 2024.
Overview of Lp(a) structure and genetics, with emphasis on its role in inflammation, atherogenesis, and clinical risk assessment.
https://pubmed.ncbi.nlm.nih.gov/37506332/