High lipoprotein (a)

What is lipoprotein (a) or Lp(a)?

Lipoprotein (a) or Lp(a) is a type of lipoprotein made by your liver. Lipoproteins are little groups of proteins and fats that help carry fats around your body.

Lp(a) is made up of:

• a lipoprotein, similar to low density lipoprotein or LDL (sometimes called “bad” cholesterol)
• two proteins called ApoB and Apo(a).

Apo(a) makes Lp(a) stickier. Because it's sticky and travels around your body in your blood, having higher levels of Lp(a) can increase your risk of getting a blood clot.

Having high levels of Lp(a) can also increase your risk of cardiovascular disease, such as a heart attack or stroke. It can also increase your risk of developing a heart condition called calcific aortic valve stenosis.

Your Lp(a) levels are determined by the genes you get from your biological parents.

How are high levels of Lp(a) diagnosed?

High levels of Lp(a) are diagnosed by having a blood test. However, Lp(a) is not routinely checked.

Your doctor may refer you to a specialist lipid clinic to have your Lp(a) levels checked if you have:

• a family history of high levels of Lp(a)
• family history of coronary heart disease at an early age, usually under 60 years old
• familial hypercholesterolaemia (FH) or other inherited lipid condition
• calcific aortic valve disease or a family history of this condition.

You only need to have your Lp(a) levels checked once.

What’s a high level of Lp(a)?

What your Lp(a) levels mean:

• normal – below 32nmol/L
• slightly increased risk – 32 to 90nmol/L
• moderate risk – 90 to 200nmol/L
• high risk – 200 to 400nmol/L
• very high risk – more than 400nmol/L.

How can I lower my Lp(a) levels?

Healthy lifestyle changes

Your Lp(a) levels are not affected by lifestyle factors. However, it’s still important to have a healthy lifestyle and manage other risk factors, like high cholesterol.

There’s lots you can do to help lower your cholesterol:

• try ways of getting more active, which will help lower your cholesterol but also help you sleep better and feel more energetic
• cut down on alcohol and stop smoking
• enjoy trying recipes that are good for your heart and eat less of foods that can increase your cholesterol.

Treatments

You may be given statins to lower your risk of cardiovascular disease. While statins do not directly reduce your Lp(a) levels, they can help make Lp(a) smaller.

There are also treatments a specialist may recommend, such as:

• lipoprotein apheresis
• PCSK9 inhibitors.

Currently there are no approved treatments to reduce Lp(a) levels but there are clinical trials looking at other treatments.

Is Lp(a) genetic?

Your Lp(a) levels are determined by the genes you get from your biological parents.

Some people may be more likely to have high levels of LP(a). Speak to your doctor about your risk if you’re worried.

Get support

• Our cardiac nurses can help answer your questions. Call, email or live chat with them on our Heart Helpline.
• Sign up to Heart Matters for healthy recipes, new activity ideas, and expert tips for managing your health.
• Find information and support from Heart UK, the cholesterol charity.