Lipoprotein (a)

What is lipoprotein (a)?

Lipoprotein (a) or Lp (a) is one kind of LDL or low-density lipoprotein. LDLs (cholesterol or fats) can cause issues because they can make speed bumps of plaque that slow down your blood’s ability to flow through your arteries. Enough of these speed bumps can give you a blood-stopping blockage.

To make things worse, lipoprotein (a) makes your blood clot more and makes it harder for blood clots to break down. Blood clots are also like speed bumps. And inflammation from lipoprotein (a) makes it more likely that those speed bumps of plaque will break open, attracting more blood clots.

Is lipoprotein (a) genetic?

Yes. The genes you get from your biological parents decide your lipoprotein (a) level. The amount of lipoprotein (a) you have as a child will most likely be the level you have for years to come.

How do I find out my lipoprotein (a) level?

A blood test can tell you your lipoprotein (a) level. A healthcare provider may need to make a special request for this test. It’s not part of a standard lipid panel that checks the kinds of cholesterol everyone talks about.

Why would a provider want to check my lipoprotein (a) level?

A provider may want to check your lipoprotein (a) level if you already have other factors that put you at a high risk for heart disease. These factors may include:

• A biological family history of heart disease.
• Familial hypercholesterolemia. More than 30% of people with this condition also have high lipoprotein (a).
• High LDL levels from your most recent lipid panel test.
• History of premature coronary artery disease (either you or your family).
• Recurrent heart events (like heart attacks and stroke) despite having risk factor management.
• If your family member has elevated lipoprotein (a).

What can affect my lipoprotein (a) blood test results?

Menopause and some medicines can affect your results. These medicines include:

• Estrogen supplements you take by mouth.
• Niacin.

What is a normal lipoprotein (a) level?

The lipoprotein (a) normal range is less than 30 milligrams per deciliter (mg/dL) of blood.

Abnormal results are:

• Borderline risk (14 to 30 mg/dL).
• High risk (greater than 31 to less than 50 mg/dL).
• Highest risk (higher than 50 mg/dL).

Some researchers say it’s more accurate to measure the number of lipoprotein (a) particles in your blood than using mass units like they do with mg/dL results. Results that measure how many particles you have will be in nanomoles per liter (nmol/L). High lipoprotein (a) is higher than 100 nmol/L.

Ask your provider which kind of measurement they’re using.

What does it mean when your lipoprotein (a) is high?

If you have high lipoprotein (a), you may be more likely to have cardiovascular (heart and blood vessel) disease. This can be true even if your other cholesterol numbers are OK.

Research supports a connection between high lipoprotein (a) and high risk of these issues:

• Heart disease.
• Heart attack.
• Heart failure.
• Peripheral artery disease (PAD).
• Aortic valve stenosis (narrowing).
• Stroke.
• Coronary artery disease.

How common are high lipoprotein (a) levels?

An estimated 20% of people worldwide have high lipoprotein (a) levels.

What are the symptoms of high lipoprotein (a)?

A lot of people don’t have symptoms of high lipoprotein (a). But if someone in your family has it, ask your healthcare provider if you should get a test.

How do I lower my lipoprotein (a)?

Researchers are currently developing and testing many drugs that lower lipoprotein (a). At the current time, none of them has U.S. Food and Drug Administration approval.

Still, you can do other things to make your heart healthier.

You can:

• Stop using tobacco products.
• Exercise regularly.
• Stay at a weight that’s healthy for you.
• Eat heart-healthy foods.
• Manage your blood pressure and diabetes.
• Use medicine to manage your LDL cholesterol.
• Manage stress in your daily life.

What can my provider do to lower my lipoprotein (a) level?

Providers can prescribe medication to treat high lipoprotein (a), like:

• Statins.
• PCSK9 inhibitors.
• Aspirin.

Researchers are trying to develop other treatments because medicines don’t lower lipoprotein (a) that much.

In rare cases, your provider may be able to use apheresis, which takes lipoprotein (a) out of your blood. This is similar to how dialysis takes waste out of your blood when your kidneys don’t work well. Only people with familial hypercholesterolemia can have this treatment, though. The treatment takes at least three hours and you have to do it every week or two.

A note from Cleveland Clinic

You may feel overwhelmed sorting out several different kinds of cholesterol. If your healthcare provider is talking about lipoprotein (a) as well, ask questions to be sure you understand why this matters. Deciding your risk of heart and blood vessel disease should include a discussion between you and your provider. They can work with you to make changes to what you can modify if you need to reduce your risk of cardiovascular disease.