Lipoprotein(a) is mostly set by genetics and stays fairly stable through adult life, unlike LDL cholesterol. European guidance advises measuring it at least once in every adult, and it is most useful after a premature coronary event, with a strong family history, or when LDL is controlled but events recur.
Statins do not lower it. A high value is a reason to lower other risk factors further, and to offer testing to first-degree relatives.
- Measure Lp(a) at least once in adulthood, especially after a premature coronary event
- One result is usually enough — levels are largely genetic
- Offer cascade testing to first-degree relatives of someone with a very high level
- A high value means pushing LDL, blood pressure and smoking harder
Why it matters
It is the one lipid result that changes risk estimates without changing month to month.
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