Lipoprotein (a)

The normal reference range for Lipoprotein (a) is Below 75 nmol/L (roughly under 30 mg/dL) is considered low risk; above 125 nmol/L (about 50 mg/dL) marks meaningfully increased cardiovascular and aortic-valve risk. Units vary between labs — nmol/L and mg/dL are not interchangeable, so check which your report uses.. Reference ranges may vary between laboratories, so always consult your healthcare provider for interpretation.

Elevated Lp(a) significantly increases cardiovascular risk independent of other factors and doesn't respond to traditional cholesterol-lowering approaches.

Lp(a) is around 80-90% genetically determined by the LPA gene, so a high level is usually inherited and remains relatively stable throughout life. About 1 in 5 people worldwide carry a high Lp(a). Levels can be modestly raised by kidney disease, an underactive thyroid, and menopause. Importantly, statins do not lower Lp(a) and may slightly raise it, which is why it is assessed separately from routine cholesterol.

A low Lp(a) is favourable and carries no health concern. Lower levels are largely genetic, but oestrogen and an overactive thyroid can reduce it. Emerging therapies (PCSK9 inhibitors modestly, and investigational RNA-based drugs substantially) can lower Lp(a), though treatment is currently focused on managing all other risk factors aggressively.

Because it is genetically set, Lp(a) usually only needs to be measured once in a lifetime to establish your inherited risk — ideally in anyone with premature heart disease, a strong family history, or familial hypercholesterolaemia. Repeat testing is only needed if a specific Lp(a)-lowering therapy is being monitored.