You’ve probably heard that you should keep your blood pressure and cholesterol at healthy levels. Your doctor may even check your cholesterol levels once or twice each year. Perhaps you stay physically active or eat a healthy diet. Even if all of these things are true, there is a good chance that you’re unfamiliar with lipoprotein (a), or Lp(a), “Lp little a”, and that you haven’t been tested for high levels.
High levels of Lp(a) are unique and can be dangerous for you. There are over 60 million Americans with high Lp(a) levels and most of them have no idea that their levels are elevated. Each of those people is at an increased risk of having a heart attack, stroke, or peripheral artery disease.1,2 Black people of African descent have the highest levels of Lp(a) of all ethnicities.3,4
If you haven’t already, learn about what Lp(a) is here before diving in.
Should You Get Your Lipoprotein(a) Levels Tested?
If you have risk factors or are at an increased risk for elevated Lp(a) levels, you should talk to your doctor about getting tested. An Lp(a) screening is a separate blood test that isn’t usually included in your normal blood work or cholesterol testing.5,6 If you haven’t ever requested this test, there is a good possibility that you haven’t been tested. Many people with high Lp(a) levels don’t have symptoms.7 You will need to be tested to confirm that your levels are elevated.
Risk Factors for Elevated Lipoprotein(a) Levels
- Family history of heart disease before age 55 in men or age 65 in women Lp(a) is one of the leading inherited risks for cardiovascular (heart) disease1,2,5
- Personal history of heart attack, coronary artery disease, or stroke1,2,5
- African or South Asian ancestry7,8
- Familial hypercholesterolemia (FH)2,6,9 About 30% of people with FH also have elevated Lp(a) levels
- Poor circulation in your legs because of peripheral arterial disease1
- Women over age 501
- High LDL cholesterol, even if you take medication to lower it5
In addition, having diabetes or chronic kidney disease puts you at increased risk of having elevated Lp(a).10
Lipoprotein(a) Screening
An Lp(a) screening is a blood test that you can have done at your doctor’s office. It’s not usually included in your regular blood work so you will need to ask for it. It’s a simple test that shouldn’t take long to complete.
What Are Normal Lipoprotein(a) Levels?
Normal levels of Lp(a) are less than 30mg/dL. Borderline levels are 30mg/dL to 50mg/dL which can put you at a high risk of heart disease. Elevated Lp(a) levels are greater than 50mg/dL, which puts you at the highest risk for heart disease.2,11
Image Adapted from Uncover Lp(a)
Will your health insurance cover the Lp(a) screening?
Lp(a) testing is often covered by health insurance plans but each plan is different and you will need to contact your insurance company to ask them if they will cover the test. If they ask you for more details about the test, you can provide them with CPT code 83695. If your health insurance doesn’t cover the test, ask your doctor about pricing and resources that may be able to help.12
5 Helpful Questions to Ask Your Doctor About Lipoprotein(a) Testing
- Am I at risk for elevated lipoprotein(a) levels?
- Can I have my lipoprotein(a) levels tested?
- What things can I do to lower my cholesterol levels?
- How can I decrease my risk for developing heart disease?
- Will my current cholesterol medication work for increased lipoprotein(a) levels?
References
- American Heart Association (2024) Lipoprotein a risks https://www.heart.org/en/health-topics/cholesterol/genetic-conditions/lipoprotein-a-risks
- National Heart, Lung, and Blood Institute (2024) Lipoprotein(a): What to know about elevated levels https://www.nhlbi.nih.gov/news/2024/lipoproteina-what-know-about-elevated-levels
- Atherosclerosis (2022) Lipoprotein(a) and ethnicities https://www.sciencedirect.com/science/article/abs/pii/S0021915022001824
- Family Heart Foundation (2024) Black American Risks for Heart Disease and Stroke https://familyheart.org/black-american-risks
- National Heart, Lung, and Blood Institute (2024) Blood Cholesterol Diagnosis https://www.nhlbi.nih.gov/health/blood-cholesterol/diagnosis
- American Heart Association (2024) Lipoprotein (a) https://www.heart.org/en/health-topics/cholesterol/genetic-conditions/lipoprotein-a
- Medline Plus (2022) Lipoprotein (a) Blood Test https://medlineplus.gov/lab-tests/lipoprotein-a-blood-test/
- Mehta Anurag (2022) Lipoprotein(a) and ethnicities https://pubmed.ncbi.nlm.nih.gov/35606075/
- American Heart Association (2024) Black People, Heart Disease, and Stroke https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/african-americans-and-heart-disease-stroke Endotext (2024) Introduction to Lipids and Lipoproteins https://www.ncbi.nlm.nih.gov/books/NBK305896/
- American College of Cardiology (2019) Lipoprotein (a) in Clinical Practice https://www.acc.org/Latest-in-Cardiology/Articles/2019/07/02/08/05/Lipoproteina-in-Clinical-Practice
- Current Opinion of Lipidology (2021) The impact of Race and Ethnicity on Lipoprotein (a) Levels and Cardiovascular Risk https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087179/
- Atherosclerosis (2022) Lipoprotein(a) and ethnicities https://www.sciencedirect.com/science/article/abs/pii/S0021915022001824
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