An Lp(a) blood test measures lipoprotein(a), a cholesterol-carrying particle whose level is set almost entirely by your genes. Unlike LDL, it barely moves with diet, exercise, or most medications, and it stays stable for life. That is why most people need the test only once: a single result tells you your lifelong baseline. Roughly one in five people has a high Lp(a), which independently raises the risk of heart attack, stroke, and aortic valve disease, and most of them have never been tested.
Key takeaways
• Lp(a) is inherited and stable; one test is usually enough.
• Commonly used high thresholds: 50 mg/dL or 125 nmol/L (ranges vary by lab).
• It raises cardiovascular risk independently of LDL.
• A high result changes how aggressively other risk factors are managed.
What Lp(a) is
Lipoprotein(a) is an LDL-like particle with an extra protein, apolipoprotein(a), attached. The extra protein makes it stickier in artery walls and more likely to promote clotting. How much you make is determined by the LPA gene, which is why levels run in families and vary little over a lifetime.
Why one test is enough
Because Lp(a) is genetically set, repeat testing rarely changes the answer. Guidelines increasingly recommend measuring it once in every adult, and certainly in anyone with a family history of early heart disease, a personal history of events despite well-controlled LDL, or aortic valve stenosis. A repeat is only useful if the first test was done during acute illness, pregnancy, or with a method the clinician doubts, or if Lp(a)-lowering treatment is started.
Reading your result
Labs report Lp(a) in mg/dL or nmol/L, and the two are not directly convertible. Commonly used thresholds for high risk are around 50 mg/dL or 125 nmol/L, with risk rising further at higher levels. Ranges vary by lab, and your August report shows the applicable range. See the Lp(a) test guide and the heart health blood tests guide.
What a high Lp(a) changes
Lifestyle changes have little effect on Lp(a) itself, and statins do not lower it. What a high result does is raise your overall risk, which means:
• Treating LDL and ApoB more aggressively, since lowering them offsets the added risk
• Managing blood pressure, blood sugar, and smoking firmly
• Considering earlier imaging, such as a coronary calcium score, in some cases
• Telling first-degree relatives, who have a 50% chance of sharing the trait
• Discussing specific therapies: PCSK9 inhibitors lower Lp(a) modestly, and dedicated Lp(a)-lowering drugs are in late-stage trials
See ApoB vs LDL for why ApoB matters alongside Lp(a).
Who should test
Every adult once, by increasingly common guideline advice, and especially: family history of early heart disease or high Lp(a); a heart attack or stroke at a young age or despite low LDL; aortic valve stenosis; or South Asian or African ancestry, where high levels are more common. No fasting is needed.
Testing with August
Lp(a) is included in August’s heart health panels alongside the lipid panel, ApoB, hs-CRP, and homocysteine. Order from the lab tests catalog, choose an at-home draw or a lab visit, and get results typically the next day with clinician review. One all-inclusive price, no membership required. August Care members ($29 a month, cancel anytime) get up to 50% off next-day lab tests, a first clinician consultation included, later consultations at $19, and AI action plans on results.
Frequently asked questions
Why do I only need to test Lp(a) once?
Because it is set by genetics and stays stable through life. One result gives your lifelong baseline.
What is a high Lp(a)?
Commonly 50 mg/dL or 125 nmol/L and above, with risk rising at higher levels. Ranges vary by lab.
Can I lower Lp(a) with diet or exercise?
No meaningful effect. Management focuses on lowering other risk factors; targeted drugs are in development.
Do statins lower Lp(a)?
No. They lower LDL, which is still worth doing to offset Lp(a) risk. PCSK9 inhibitors lower Lp(a) modestly.
Is Lp(a) part of a standard lipid panel?
No. It must be ordered separately or as part of an advanced heart panel.
Should my family be tested if mine is high?
Yes. First-degree relatives have a 50% chance of inheriting the trait.
Do I need to fast for an Lp(a) test?
No.
Can I test Lp(a) at home?
Yes. An August phlebotomist draws the sample at home, with results typically the next day.
