Encyclopedia entry
Lp(a)
Oliver Mackman · Editorial director · Best Business Loans Ltd (16833937)
Last updated 2026-05-22
Lipoprotein(a), pronounced "L-P-little-a", is a genetically-determined cholesterol-carrying particle that elevates cardiovascular risk independently of LDL and ApoB. Levels are set by inheritance of the LPA gene and barely move with diet, exercise, statins, or weight loss. Approximately 20 percent of the UK population has elevated Lp(a). Every adult benefits from measuring it once.
Why Lp(a) matters
Elevated Lp(a) (defined as above 50 mg/dL or above 125 nmol/L depending on assay) doubles or triples the lifetime risk of cardiovascular events. The mechanism combines atherogenic effects (similar to LDL) with prothrombotic effects (similar to plasminogen, which Lp(a) structurally resembles). Patients with elevated Lp(a) often have a family history of premature cardiovascular disease and may have presented with events at unexpected ages despite normal LDL.
Why measuring once is enough
Lp(a) levels are roughly 90 percent genetically determined. Once measured in adulthood, the result is stable for life. There is no need to re-test annually. The exception is if a new ultra-effective Lp(a)-lowering therapy launches and the patient becomes a candidate; current 2026 therapies in development include olpasiran and pelacarsen, in phase III trials.
What to do if elevated
- · Aggressive management of all other cardiovascular risk factors (LDL, ApoB, blood pressure, blood glucose).
- · Consider statin therapy at higher intensity (statins do not lower Lp(a) but the overall cardiovascular benefit applies).
- · Discuss cardiology referral, particularly if family history is strong.
- · Lifestyle changes alone do not lower Lp(a) materially. Weight loss does not move it. GLP-1 medications do not move it.
Your prescriber decides on therapy. We do not recommend specific treatments to specific people.
UK access
NHS Lp(a) testing is uncommon in primary care; usually triggered by family history or unexplained cardiovascular events. Private testing via Medichecks, Randox, Thriva, and UK longevity clinics costs £15 to £40 standalone or as part of a comprehensive lipid panel. UK longevity providers include it in baseline bloods.
Related: ApoB · longevity hub.