Lab marker
Lipoprotein(a)
Lp(a) · Lipoprotein little-a
A heritable, near-unmodifiable atherogenic particle. Most people should know their level once — the result almost never changes.
What it measures
Lipoprotein(a) is an LDL-like particle covalently bound to apolipoprotein(a). Concentration is ~70–90% genetically determined and stable for life from young adulthood. Elevated Lp(a) is an independent causal risk factor for atherosclerotic cardiovascular disease and aortic valve stenosis.
Reference context
3 guideline sources
Roughly 20% of the global population carries elevated Lp(a) (>125 nmol/L) — often clinically silent until an early CV event. No current therapy specifically lowers Lp(a) outside of trials (pelacarsen Phase III ongoing); knowing your level shapes how aggressively you target other modifiable risk factors (ApoB, BP, smoking).
Population context — consult guideline targets below
Mechanism
Why moving this marker matters
Lp(a) particles enter the arterial wall like LDL but resist clearance and additionally promote thrombosis and inflammation. Mendelian-randomisation studies have established causality for ASCVD and aortic stenosis.
Guideline targets
What major guidelines recommend
ESC 2019 (low risk)
<75 nmol/L (<30 mg/dL)
ESC 2019 (high risk)
>125 nmol/L (>50 mg/dL) — risk-enhancing factor
ACC/AHA 2018
≥50 mg/dL is a risk-enhancing factor justifying earlier or more intensive lifestyle/pharmacotherapy decisions
How to measure
The test, where to get it, when to repeat
Method
Standard blood draw. Modern assays report in nmol/L (mass-independent, preferred) or mg/dL. Fasting not required.
Where
Through your GP on request, or private lab. Often not on standard panels — must usually be requested specifically.
Typical cost
€15–40 private.
Fasting
Not required
When to test
ESC 2019 dyslipidaemia
20+Measure at least once in every adult's lifetime; reasonable in young adulthood. Repeat testing usually not needed.
Lp(a) Foundation consensus
One-time screening recommended for all adults due to heritability + lifelong stability.
Where to test
Independent labs offering this test
Healicus refers you to independent laboratories. You order from the lab; they take the sample, run it, and return your result on their own platform. Healicus never sees your value.
Randox Health
UK · EU · INTLClinic-based premium panels — wider biomarker breadth than home-test brands.
Visit Randox Health
Synlab
DE · EU · INTLEurope-wide medical lab network — referrals via partner GPs and direct-to-consumer programmes where offered.
Visit Synlab
Medichecks
UKUKAS-accredited home blood-test panels with GP-equivalent biomarker coverage.
Visit Medichecks
Thriva
UKApp-first subscription home testing, capillary draw, clinician-reviewed reports.
Visit Thriva
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Context
Reading the numbers
Roughly 20% of the global population carries elevated Lp(a) (>125 nmol/L) — often clinically silent until an early CV event. No current therapy specifically lowers Lp(a) outside of trials (pelacarsen Phase III ongoing); knowing your level shapes how aggressively you target other modifiable risk factors (ApoB, BP, smoking).
Caveats
Assay variability between methods is meaningful; track in the same units (nmol/L preferred). Acute inflammation can transiently elevate Lp(a).
See also
Related markers
Take to your physician
Worth discussing
- Whether your Lp(a) shifts your overall cardiovascular risk estimate enough to change action.
- How aggressively to target other modifiable risk factors (ApoB, BP, smoking) given a non-modifiable elevated Lp(a).
- Family history — first-degree relatives have a meaningfully elevated probability of also being high.
Sources
Cited literature
Edited by Carl Pöhl, MD · Healicus editorial
Last reviewed May 2026
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