Most people are familiar with cholesterol testing — HDL, LDL, and triglycerides — but there’s another critical marker that often goes unchecked: Lipoprotein(a), or Lp(a).

Lp(a) is a genetically inherited lipoprotein that closely resembles LDL cholesterol, but it carries an additional protein called apolipoprotein(a). This unique structure makes Lp(a) more inflammatory, clot-forming (thrombogenic), and artery-damaging (atherogenic) than regular LDL.

 Why Lp(a) Matters

 Independent Risk Factor for Cardiovascular Disease

High Lp(a) is a strong, independent risk factor for:

  • Coronary artery disease

  • Aortic valve stenosis

  • Ischemic stroke

What’s most concerning is that these risks exist even when standard cholesterol numbers appear normal. Someone can have “perfect” LDL, HDL, and triglycerides — yet still carry significant hidden risk due to elevated Lp(a).

 Genetically Determined Levels

Unlike most cholesterol markers, Lp(a) is almost entirely genetic — about 90% inherited.
That means:

  • Levels stay relatively constant throughout life

  • Diet, exercise, and statins usually don’t lower it significantly

Because lifestyle changes don’t affect Lp(a), identifying elevated levels early is key for long-term risk management.

 Promotes Plaque and Clot Formation

The attached apolipoprotein(a) interferes with your body’s ability to break down blood clots and increases inflammation in the arteries.
This combination speeds up plaque buildup, hardening of arteries, and overall cardiovascular inflammation — all of which raise the risk for heart attack and stroke, even in younger individuals.

 Often Missed in Standard Lipid Panels

Lp(a) is not included in routine cholesterol testing. Many people never know their level until a major cardiovascular event occurs.

If you or a family member have had:

  • A heart attack or stroke at a young age

  • “Normal” cholesterol but unexplained cardiovascular disease

  • Persistent high LDL despite treatment

…it’s time to ask for an Lp(a) test.

 New Therapies Are on the Horizon

Cutting-edge treatments targeting Lp(a) directly — such as antisense oligonucleotides — are now in advanced clinical trials. These new therapies may dramatically lower Lp(a) and reduce risk in those with elevated levels.

Knowing your Lp(a) status now can help guide your eligibility for these future treatment options.

 Who Should Get Tested

  • Personal or family history of early heart attack or stroke

  • Elevated LDL that doesn’t respond to therapy

  • Aortic valve disease or calcification

  • Unexplained heart disease despite “normal” lipid levels

 Lp(a) Testing at Labs By Request

At Labs By Request, we make it easy to get the answers you need:

  • No doctor’s referral required

  • Affordable, transparent pricing

  • Results you can review with your provider or specialist

  • Fast turnaround and walk-in availability

Testing is simple — and the insight it provides can be life-changing.

 Bottom Line

Lipoprotein(a) is one of the most under-tested yet most predictive markers of cardiovascular risk.
You can’t change your genes, but you can know your numbers — and take steps to reduce your overall risk through early detection, inflammation control, and targeted prevention.