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Heart health

Lipoprotein(a)

Also known as: Lp(a), Lp little a, Apolipoprotein(a)-bound LDL

A lipoprotein(a) [Lp(a)] test measures the concentration of a unique type of cholesterol particle in your blood. Unlike low-density lipoprotein (LDL or “bad cholesterol”), which is influenced by diet and lifestyle, Lp(a) levels are primarily determined by genetics and remain relatively stable throughout life. High levels of Lp(a) are linked to a higher risk of heart attack, stroke, and aortic valve disease — even if your other cholesterol numbers are normal.

A provider can help determine whether you might benefit from an Lp(a) test, especially if you have a strong family history of heart disease. They can also review your results, recommend further testing, and help coordinate preventive strategies and prescriptions when needed.

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Key takeaways

  • Sample required: Blood

  • Tests for: Lipoprotein(a), a type of lipid (fat) linked to cardiovascular risks like heart attack and stroke.

  • Healthy range: Individuals with Lp(a) less than 30 milligrams per deciliter (mg/dL) are considered at low risk; 30–50 mg/dL is intermediate risk; greater than 50 mg/dL is elevated risk.

What can an Lp(a) test tell you?

An Lp(a) test can provide insight into:

  • Inherited cardiovascular risk. Elevated Lp(a) is an independent risk factor for heart disease.

  • Silent contribution to disease. Lp(a) doesn’t usually cause symptoms but increases the likelihood of developing arterial plaque, inflammation, and clot formation.

  • Risk management. Providers use results to guide treatment, often intensifying LDL-lowering therapy or monitoring more closely if Lp(a) is high.

The National Lipid Association notes that one-time Lp(a) testing for every adult may be reasonable, but that screening is especially important for people with strong family histories or unexplained early heart disease.

What is being tested?

Lipoprotein(a) is made up of a low-density lipoprotein (LDL) particle attached to a unique protein called apolipoprotein(a). This structure makes Lp(a) more likely to stick to artery walls, trigger inflammation, and promote blood clots. Because the gene for apolipoprotein(a) is inherited, Lp(a) levels vary widely among people but are generally stable throughout a person’s life.

Where is the Lp(a) test typically included?

Unlike cholesterol and triglycerides, Lp(a) is not part of a standard lipid panel. Instead, it is usually ordered separately when:

  • A person has early or repeated cardiovascular events despite normal cholesterol

  • There is a strong family history of premature heart disease

  • Genetic lipid disorders such as familial hypercholesterolemia are suspected

Lp(a) testing is included as part of lab testing through Hers, which goes beyond standard lab tests to help you understand what’s really going on in your body and either address or get ahead of problem areas with a tailored action plan.

Who should get an Lp(a) test?

You may benefit from an Lp(a) test if:

  • You have a family history of early heart disease or stroke.

  • You have had cardiovascular events (like a heart attack) despite otherwise normal cholesterol levels.

  • You have high LDL that doesn’t respond as expected to treatment.

  • Your provider suspects an inherited lipid disorder.

Some professional groups recommend a one-time Lp(a) measurement for all adults, especially those at intermediate or high cardiovascular risk.

How Labs by Hers works

  • 1

    Book your test

    Schedule a lab draw in the Hers app at one of more than 2,000 convenient locations.

  • 2

    Get your results

    Review your lab results to understand which areas of your health may need attention.

  • 3

    Spot early signals

    Identify potential health risks or system imbalances before they become more serious.

  • 4

    Get your action plan

    Receive expert guidance tailored to your health profile and test results.

  • 5

    Improve over time

    Track your progress through a mid-year panel and ongoing provider check-ins.

Not available in all 50 states. Eligibility and provider order required. Lab results alone are not intended to diagnose, treat, or cure any condition. A provider will reach out about critical results and plans include access to 24/7 provider messaging.

Images for illustrative purposes only.

Frequently asked questions

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What causes changes in Lp(a) levels?

Lipoprotein(a), or Lp(a), levels are largely determined by genetics, unlike other lipids such as LDL or triglycerides. Lifestyle changes like diet and exercise have minimal impact, though certain factors can cause small fluctuations. Higher Lp(a) levels are most often inherited but may also be seen with kidney disease, inflammation, pregnancy, growth hormone therapy, or hypothyroidism.

Lower Lp(a) levels are less common and may occur with specific genetic variants, certain Lp(a)-lowering treatments under study (such as PCSK9 inhibitors or antisense therapies), hyperthyroidism, menopausal hormone therapy, or liver disease. Because Lp(a) is primarily genetic, testing helps identify inherited cardiovascular risk rather than changes driven by lifestyle.

What is a normal range for Lp(a)?

Individuals with Lp(a) less than 30 milligrams per deciliter (mg/dL) are considered at low risk; 30–50 mg/dL is intermediate risk; greater than 50 mg/dL is elevated risk

Can this test be done at home?

Some at-home kits may include Lp(a) testing, but availability is limited. 

Do I need to fast before an Lp(a) test?

No. Unlike standard cholesterol tests, fasting is not required.

How often should I get tested?

Usually once. Because levels are genetically determined, repeat testing is not often necessary unless your provider needs to confirm results or evaluate changes in risk.

What conditions are linked to high Lp(a)?

Elevated Lp(a) is associated with heart disease, including heart attack, stroke, and other cardiovascular conditions.

Are there treatments to lower Lp(a)?

Currently, no widely available drugs specifically target Lp(a). Some therapies in development show promise. For now, treatment focuses on lowering LDL and managing overall risk.

What tests are related to this biomarker?

• Lipid panel (total cholesterol, LDL, HDL, triglycerides)

Apolipoprotein B (apoB)

• Genetic testing for familial hypercholesterolemia

• Coronary artery calcium scoring

The information provided here is for informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk to a qualified healthcare provider about your specific health concerns.

Related biomarkers

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Apolipoprotein B

Apolipoprotein B (ApoB) is a protein that carries LDL and other bad cholesterol particles in the blood. Lower ApoB levels mean fewer harmful cholesterol particles are in your blood, and an overall reduced risk for heart disease.

Learn more about Apolipoprotein B

High-Sensitivity C-Reactive Protein

High-Sensitivity C-Reactive Protein (hs-CRP) is a liver-made protein that rises with inflammation. A low level is associated with a lower heart disease risk.

Learn more about High-Sensitivity C-Reactive Protein

Non-HDL Cholesterol

Non-HDL cholesterol includes all the "bad" types of cholesterol that can build up in your arteries. A healthy level is a good sign for your overall heart health.

Learn more about Non-HDL Cholesterol

HDL Cholesterol

HDL, or “good” cholesterol, acts like a cleanup crew to clear harmful fats from your blood. A healthy HDL level helps prevent buildup in your arteries.

Learn more about HDL Cholesterol

LDL Cholesterol

LDL is the “bad” cholesterol linked to plaque buildup in artery walls. A healthy level means fewer harmful cholesterol particles in your blood, which reduces overall risk for plaque buildup.

Learn more about LDL Cholesterol

Total Cholesterol

Total cholesterol is the total amount of all cholesterol types, including HDL, LDL, and other blood fats, and gives a general snapshot of your cholesterol status. When the number is in a good range, it shows a lower risk of developing heart disease.

Learn more about Total Cholesterol

Cholesterol/HDL Ratio

This ratio compares your total cholesterol to HDL, the "good" cholesterol.

Learn more about Cholesterol/HDL Ratio

Triglycerides

Triglycerides are a type of fat in your blood made from unused calories that are stored for energy. Low triglyceride levels indicate that your body is not having problems with insulin resistance or processing fat, which is good.

Learn more about Triglycerides

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Supporting references

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Reviewed by Lynn Marie Morski, MD

Published 12/04/2025