At your next blood draw, ask for one extra line on the order: lipoprotein(a), written Lp(a). It is not part of a standard cholesterol panel, so it only gets ordered if someone asks.
Lp(a) is a cholesterol-carrying particle linked to heart attack, stroke and narrowing of the aortic valve. Your level is almost entirely set by your genes.
That is the uncomfortable part. You can eat well, train hard and keep a beautiful LDL, and still carry a high Lp(a) you have never seen.
The ESC/EAS 2025 dyslipidaemia guidelines put the risk-enhancing cutoff above 50 mg/dL, or 105 nmol/L. At least one in five people is above it.
The same guidelines recommend measuring Lp(a) in every adult at least once. Because it barely changes over a lifetime, a single result usually does the job.
There is one exception that matters for you. Hormonal changes around menopause can raise Lp(a), so a repeat test after menopause makes sense if an earlier result was borderline.
Lifestyle changes have little effect on the number itself. What a high result changes is how seriously your other risk factors get treated.
A high Lp(a) can move LDL, blood pressure and blood sugar from “keep an eye on it” to “act now”. It can also be a reason to test your siblings and children.
Here is the move. At your next appointment, say: “I’d like a one-time lipoprotein(a) test added to my lipid panel. If it’s high, how does that change my targets?”
When the result comes back, check the unit. Above 50 mg/dL or 105 nmol/L counts as risk-enhancing, and the further above, the more it weighs.
This is a number you only need once, and it changes how every other number gets read. Get it on file.
