Recent national research highlights a silent cardiovascular danger that many Americans may be unaware of. A 2026 analysis of three National Institutes of Health trials found that one in five adults have elevated lipoprotein(a) levels, a genetic marker that significantly increases the risk of stroke and cardiovascular death.
What is lipoprotein(a)?
Lipoprotein(a), or Lp(a), is a cholesterol‑carrying particle that resembles low‑density lipoprotein (LDL) but carries an additional protein called apolipoprotein(a). This extra protein makes the particle especially “sticky,” allowing it to cling to artery walls, promote plaque buildup, and interfere with the body’s ability to dissolve blood clots.
How much risk does a high Lp(a) level add?
The NIH analysis reported that people with elevated Lp(a) have a 64% higher risk of stroke and a 49% higher risk of cardiovascular death compared with those whose levels are lower. The risk becomes most pronounced at levels of 175 nanomoles per liter (nmol/L) or higher, although the American College of Cardiology flags levels at 125 nmol/L as elevated.
Why so few Americans are tested
Despite the clear danger, fewer than one percent of U.S. adults have ever been screened for Lp(a). Standard cholesterol panels do not include the test, and many physicians cite the lack of an FDA‑approved medication that directly lowers Lp(a) as a reason to forego testing. Dr. Abid Husain, a cardiologist at the Boulder Longevity Institute, argues that this perception is mistaken: “Practitioners and patients are left thinking there’s nothing that can be done, which couldn’t be further from the truth.”
How doctors respond to a high result
When a patient’s Lp(a) is high, clinicians typically focus on aggressively managing other modifiable risk factors—LDL cholesterol, blood pressure, blood sugar, weight, and smoking status. Statins remain the first‑line therapy because lowering overall LDL reduces the number of Lp(a) particles circulating in the bloodstream. Some physicians also consider PCSK9 inhibitors, which can modestly lower Lp(a) by about 18% while sharply reducing LDL.
Hormone therapy may help certain women; estrogen‑based treatments have shown a 25% reduction in Lp(a) among diabetic women, though evidence in men is limited. Emerging therapies such as the antisense drug lepodisiran have demonstrated up to a 94% reduction in Lp(a) in early trials, but whether these reductions translate into fewer heart attacks or strokes remains under investigation.
Can lifestyle changes lower Lp(a)?
Genetics largely determine Lp(a) levels, so lifestyle alone cannot bring the number down. However, a heart‑healthy lifestyle—regular exercise, a balanced diet, adequate sleep, weight management, and avoiding tobacco—can lessen the overall cardiovascular burden and improve outcomes for those with high Lp(a).
What patients can do now
Leading medical societies, including the American College of Cardiology and the American Heart Association, now recommend that every adult obtain an Lp(a) test at least once in a lifetime. Patients who have not been screened should ask their physicians to order the test, especially if they have a family history of early heart disease or stroke.
Knowing one’s Lp(a) status provides an opportunity for early, targeted intervention. As Dr. Husain notes, “A patient who knows that their Lp(a) is dangerously high can work with their physician to aggressively manage every other risk factor—and that could be the difference between a stroke at 55 and never having one at all.”
Original reporting: KTBS 3 (Shreveport) — read the source article.
