What does it mean if your Lipoprotein (a) result is too high?
Lipoprotein (a), often written as Lp(a), is a special type of cholesterol-carrying particle in your blood. It’s similar to LDL (“bad” cholesterol) but has an extra protein called apolipoprotein(a) attached to it. This added component makes Lp(a) more sticky and prone to causing inflammation and plaque buildup inside arteries.
Unlike most cholesterol markers, Lp(a) levels are almost entirely determined by your genes and stay relatively stable throughout life. Lifestyle choices, diet, or exercise usually have little effect on this value.
What Does It Mean If Lp(a) Is Elevated?
An elevated Lp(a) level means you may have a genetically increased risk of heart and vascular disease, even if your other cholesterol numbers look normal. High Lp(a) levels can contribute to:
-
Atherosclerosis (hardening and narrowing of arteries)
-
Heart attacks and strokes at a younger age
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Aortic valve stenosis (narrowing of a major heart valve)
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Blood clots, due to structural similarities with clotting proteins
Because Lp(a) particles are smaller and denser, they can penetrate the artery wall easily and promote inflammation and oxidation, accelerating plaque buildup over time.
Typical Reference Ranges
| Lp(a) Level | Interpretation |
|---|---|
| < 30 mg/dL (or < 75 nmol/L) | Normal — lower cardiovascular risk |
| 30–50 mg/dL (75–125 nmol/L) | Borderline — mild elevation |
| > 50 mg/dL (or > 125 nmol/L) | Elevated — higher lifetime cardiovascular risk |
Note: Some labs report results in mg/dL and others in nmol/L. Always check which unit your report uses.
Common Causes of Elevated Lp(a)
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Genetics — inherited from one or both parents (runs in families)
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Ethnicity — people of African descent often have higher levels
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Hormonal changes — levels can rise after menopause
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Chronic inflammation, thyroid or kidney disorders may worsen elevation
Because Lp(a) is genetically determined, it is not lowered effectively through diet, exercise, or most cholesterol-lowering medications.
Health Implications
Even if your LDL cholesterol and triglycerides are normal, elevated Lp(a) can:
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Increase the likelihood of artery blockages
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Worsen coronary artery disease risk
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Accelerate calcification and plaque progression
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Increase risk for stroke or heart attack
Lp(a) is an independent cardiovascular risk factor, meaning it can increase risk on its own, regardless of other cholesterol numbers.
What Can You Do?
Although Lp(a) cannot be lowered easily, you can minimize its impact by improving overall heart health:
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Lower your LDL cholesterol as much as possible (through diet, statins, ezetimibe, or PCSK9 inhibitors).
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Reduce inflammation with an anti-inflammatory diet (omega-3s, fruits, vegetables, whole grains).
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Avoid smoking and limit alcohol.
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Monitor blood pressure and blood sugar levels.
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Get family members tested — elevated Lp(a) often runs in families.
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Ask your doctor about emerging treatments — new RNA-based therapies (such as pelacarsen or olpasiran) are in clinical trials and show promising results in lowering Lp(a) significantly.
Key Takeaway
Elevated Lipoprotein (a) levels point to an inherited risk factor for heart disease and stroke. While you can’t directly lower Lp(a) yet, controlling other risk factors — especially LDL cholesterol and inflammation — can substantially reduce your overall cardiovascular risk.
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