Lp(a) (lipoprotein(a))

An inherited, lifelong cholesterol-carrying particle that adds to your heart-disease risk — and for most people you only need to measure it once.

What it measures

The blood level of lipoprotein(a), an LDL-like particle. Reported in either nmol/L (particle number) or mg/dL (mass) — the two do not convert reliably.

Why it matters

Lp(a) is largely set by your genes and is a causal, independent driver of heart disease and aortic valve narrowing. Because it barely changes over life, a single measurement usually tells you your lifetime risk contribution.

Healthy target

Lower is better; roughly < 75 nmol/L (< 30 mg/dL) rules out extra risk, > 125 nmol/L (> 50 mg/dL) rules it in. No single clean cut-off.

How to read your value

Read the value in the unit your lab reports — never convert nmol/L to mg/dL to judge risk, because there is no reliable conversion. Risk rises continuously, so a number just over the threshold is not a switch flipping.

What can affect it

• Almost entirely genetics (the LPA gene)
• Statins do NOT lower it (may nudge it up slightly)
• PCSK9 inhibitors lower it modestly
• There is no approved drug proven to lower Lp(a) and cut events yet — trials are ongoing

Does the target differ by age or sex?

Fairly stable across life. Levels run higher on average in people of African ancestry, and there are modest sex differences — but interpret against your overall cardiovascular risk, not a demographic band.

When to talk to a clinician

A high Lp(a), or a personal/family history of early heart disease or aortic stenosis, is worth discussing — interpreted alongside your total risk, not alone.