Lipoprotein(a), or Lp(a), is an LDL-like particle with an extra protein, apolipoprotein(a), attached; its level is mostly set by your genes, and a high level raises the risk of heart attack, stroke and narrowing of the aortic valve.
Also called: Lp(a), lipoprotein little a, LPA.
General information, not medical advice
Ranges and goals vary with your overall heart risk and between labs. Go through your own results with your doctor or another qualified health professional.
What it measures
The Lp(a) test measures how much of this particle is in your blood. It isn't part of a standard cholesterol test, so you usually need to ask for it. Because the level is mostly inherited and stays fairly stable through life, one test is usually enough. The 2026 ACC/AHA guideline says every adult should have Lp(a) measured at least once, and the European Atherosclerosis Society said the same in 2022.
Labs report Lp(a) in nmol/L (number of particles) or mg/dL (their weight). The particles vary in size, so there's no exact conversion: compare your result with a threshold in the same unit.
Levels
| Lp(a) | Approximate risk |
|---|---|
| Under 75 nmol/L (under 30 mg/dL) | Reference level |
| 75–124 nmol/L (30–49 mg/dL) | About 1.2 times |
| 125 nmol/L (50 mg/dL) or more | About 1.4 times; counts as a risk-enhancing factor |
| 250 nmol/L (100 mg/dL) or more | About 2 times |
Risks are compared with a typical level of about 20 nmol/L, using the 2026 guideline's figures, which it calls approximate. In the UK, Lp(a) isn't part of a standard NHS check and NICE's lipid guidance doesn't cover it, but HEART UK recommends testing people with a personal or family history of early heart disease or with familial hypercholesterolaemia.
What raises and lowers it
- Raises it: mainly your genes. Diet and exercise barely change it.
- Lowers it: PCSK9 inhibitors lower Lp(a) by about 15–30%. As of October 2026 no medicine is approved specifically to lower Lp(a); several are in large trials. Top-line results from the Lp(a)HORIZON trial of pelacarsen, released in September 2026, showed it lowered Lp(a) but didn't significantly reduce major heart events; full results are awaited.
A high result is a reason to control LDL, blood pressure and other risk factors more tightly, and for close relatives to be tested.
Deeper reading
Related terms
- ApoB
- HDL cholesterol
- LDL cholesterol
- Non-HDL cholesterol
- PREVENT risk calculator
- Triglycerides
- VLDL cholesterol
- All glossary terms
Frequently asked questions
What is a high Lp(a) level?
Under the 2026 ACC/AHA guideline, 125 nmol/L (50 mg/dL) or more is a risk-enhancing factor, linked to about 1.4 times the usual risk of heart attack and stroke. 250 nmol/L (100 mg/dL) or more is linked to about twice the risk.
Should everyone get an Lp(a) test?
The 2026 ACC/AHA guideline recommends measuring Lp(a) at least once in every adult. In the UK, HEART UK recommends testing people with a personal or family history of early heart disease, familial hypercholesterolaemia or a close relative with high Lp(a).
Can you lower Lp(a) with diet?
Not meaningfully. Lp(a) is mostly inherited. What you can change is your overall risk, by lowering LDL, blood pressure and blood sugar, not smoking and keeping a healthy weight.
Sources
- Blumenthal RS, Morris PB, et al. 2026 ACC/AHA Guideline on the Management of Dyslipidemia. J Am Coll Cardiol. 2026;87(19). Also in Circulation, doi:10.1161/CIR.0000000000001423.
- Kronenberg F, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J. 2022;43:3925–3946.
- National Lipid Association: Top-line results from the phase 3 Lp(a)HORIZON trial (September 2026)
- NICE NG238: Cardiovascular disease risk assessment and reduction, including lipid modification
Track your numbers over time
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