Biomarker guide
Lipoprotein(a) (nmol/L)
Lipoprotein(a), or Lp(a), measures a genetically determined lipoprotein particle that is independently associated with cardiovascular and aortic-valve disease. People test it, usually once in a lifetime, because levels are largely set by genes, and an elevated result reframes how aggressively other risk factors are worth managing.
Reference ranges
Commonly used adult reference ranges. Labs vary in methodology and cutoffs, interpret your results against your lab report's stated ranges and with your doctor.
Commonly used cutoffs flag Lp(a) above 125 nmol/L as high; levels are mostly genetic and stable, so a single lifetime measurement is often sufficient.
| Zone | Range |
|---|---|
| Optimal | 0–75 nmol/L |
| Borderline high | 75–125 nmol/L |
| High | 125–200 nmol/L |
The importance of Lp(a)
Lp(a) is an LDL-like particle with an extra protein tail, and blood levels are roughly 80–90% genetically determined. Diet and exercise barely move it, which makes it different from nearly every other lipid marker: it is less a lifestyle scoreboard than a piece of inherited information.
Around one in five people carries an elevated Lp(a), and most do not know it. Elevated levels are independently associated with heart attack, stroke, and aortic-valve stenosis, even in people whose LDL-C looks unremarkable. Because levels are stable over a lifetime, most guidelines suggest a single measurement is sufficient for most people.
There is currently no widely approved therapy that specifically lowers Lp(a), though several are in late-stage trials. In the meantime, an elevated result typically shifts the conversation toward managing everything else, LDL-C or ApoB, blood pressure, smoking, glucose, more assertively. If your Lp(a) is above 125 nmol/L, sharing the result with your doctor and first-degree relatives is worth considering, since the trait runs in families.
Frequently asked questions
What is a normal Lp(a) level?
Commonly used cutoffs consider Lp(a) below 75 nmol/L unremarkable, 75–125 nmol/L borderline, and above 125 nmol/L high. Some labs report in mg/dL instead, where 50 mg/dL is a frequently used high cutoff; the units are not directly convertible, so check which your lab used.
How often should I test Lp(a)?
Usually once. Because Lp(a) is roughly 80–90% genetically determined and stays stable across adulthood, most guidelines suggest a single lifetime measurement for most people, with retesting mainly relevant if new therapies become available or your clinical picture changes.
Can I lower Lp(a) with diet or exercise?
Essentially no, lifestyle changes that reliably move LDL-C and triglycerides have little effect on Lp(a). An elevated result is generally used to sharpen management of the risk factors that do respond, such as LDL-C, blood pressure, and smoking, which is a strategy worth building with your doctor.
Should my family test Lp(a) if mine is high?
It is worth raising with them. Lp(a) levels are inherited, so first-degree relatives of someone with an elevated result have a meaningful chance of carrying it too. A single inexpensive test can tell each relative where they stand, and results are best interpreted with their own doctors.
Panels that measure Lp(a)
Cardio IQ Advanced Lipid & Heart Health Testing: ApoB, Lp(a) & More
Advanced lipid, inflammation, and metabolic testing from Quest, a deeper look at cardiovascular markers than a standard cholesterol panel.
View panelHeart Health Blood Test Panels: Tiered Cardiac Risk Screening
Four tiered blood panels that measure markers associated with cardiovascular risk, from a quick baseline to a 94-biomarker deep dive.
View panelHeart Health Blood Test Panels: Lipids, ApoB, hs-CRP & More
Seven cardiovascular panels, from a six-biomarker lipid profile to a 36-biomarker deep dive, currently 20% off.
View panel