You can have textbook cholesterol, a good diet and a healthy weight and still carry a raised risk of heart disease you never knew about. One reason is lipoprotein(a), often written Lp(a) — a cholesterol-carrying particle that standard tests do not measure and that is set largely by your genes.
What is lipoprotein(a)?
Lp(a) is an LDL-like particle with an extra protein attached. Like LDL, it can build up in artery walls, but it also appears to promote clotting and inflammation, which is why it is considered an independent contributor to cardiovascular risk. Your level is roughly 80–90% determined by inheritance, so it tends to stay fairly stable throughout life.
Why standard cholesterol tests miss it
A routine lipid panel reports total cholesterol, HDL, LDL and triglycerides — but not Lp(a). Someone can therefore have "normal" cholesterol yet a high Lp(a) driving their risk quietly in the background. It has to be requested specifically, which is why many people reach middle age without ever having it checked.
Who should consider testing
Lp(a) is especially worth checking if any of the following apply:
- A family history of early heart attack or stroke — particularly before the age of 55 in men or 65 in women.
- A close relative already known to have raised Lp(a).
- Personal cardiovascular disease that seems disproportionate to your other risk factors.
- A wish for a complete picture of your inherited heart risk.
Check your Lp(a)
Our cardiac profile includes lipoprotein(a) alongside cholesterol, apolipoproteins and inflammatory markers — so you can see whether this genetic risk factor is part of your picture.
Check your Lp(a)What a high result means — and what it does not
A raised Lp(a) does not mean heart disease is inevitable. It is one risk factor among several, and there is currently no widely used medication that lowers Lp(a) specifically. What it does do is sharpen the case for managing every other factor well — keeping LDL cholesterol, blood pressure, weight and smoking firmly in check, since these remain very much within your control.
When to get checked
If early heart disease runs in your family, ask about a one-off Lp(a) test as part of a broader cardiac assessment. Knowing your number early gives you and your clinician the chance to plan a lifelong strategy rather than react after a problem has already developed.
Check your Lp(a)
Book online with OneMedicine — CQC-registered clinic in Birmingham, or a home visit / local clinic nationwide. Doctor-reviewed results, most within 24 hours.
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Specialist interest: Cardiovascular Medicine · OneMedicine, CQC-registered clinic