Lipoprotein(a) can raise heart risk even with normal cholesterol

Lipoprotein(a) (Lp(a)) is an inherited particle not measured on routine lipid panels and can increase the risk of heart attack, stroke, and aortic valve disease; experts estimate more than 20% of adults have levels that raise cardiovascular risk.

Preventive cardiologist Dr. Seth J. Baum highlighted lipoprotein(a), or Lp(a), as a common inherited particle that can raise cardiovascular risk even when standard cholesterol tests look normal. Lp(a) is similar to LDL cholesterol but includes an added apolipoprotein(a) component that promotes plaque, inflammation, and clotting. Because Lp(a) is largely determined by genetics and is not reported on routine lipid panels, many people with elevated levels are not identified. Key points: - Lp(a) is inherited, remains relatively stable through life, and is invisible on standard cholesterol tests; experts estimate over 20% of adults have levels that increase cardiovascular risk. - Elevated Lp(a) amplifies other risk factors such as mildly high LDL, borderline blood pressure, and smoking, and is associated with higher risks of heart attack, stroke, and aortic valve disease. - Testing for Lp(a) is usually done once; some specialized treatments like lipoprotein apheresis exist for selected patients, and several Lp(a)-lowering drugs are in late-stage clinical trials with outcome data and regulatory approvals still pending. Summary: Identification of elevated Lp(a) can change how clinicians interpret overall cardiovascular risk because it adds to other risk factors and may prompt different diagnostic or management choices. Research on targeted therapies is progressing, but wider treatment options depend on forthcoming outcome data and regulatory decisions.