Even if you’re still young, monitoring your cholesterol is crucial. Your cholesterol levels mean more than you might think, especially if you have conditions like obesity or diabetes. The Centers for Disease Control and Prevention advises that adults undergo cholesterol screenings every 4 to 6 years. Since cholesterol levels often rise with age, you might want to consider more frequent checkups. A standard cholesterol test measures levels of LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides.
However, a routine cholesterol screening might not detect a specific type of cholesterol known as lipoprotein(a), or Lp(a). This “stealthy” form of cholesterol is genetically inherited and affects about one in five people worldwide, according to the American Heart Association. While it is a form of cholesterol, Lp(a) is more dangerous because it has a greater tendency to adhere to the walls of blood vessels. Cleveland Clinic compares them to speed bumps in your blood vessels. Over time, these speed bumps can impede blood flow to vital organs, increasing the risk of serious cardiovascular issues. People with high Lp(a) have a heightened risk of heart attack, stroke, and coronary artery disease, even if they maintain a healthy lifestyle.
High Lp(a) doesn’t have symptoms
Like high cholesterol, having high Lp(a) doesn’t manifest symptoms. Although having a family member with high Lp(a) increases your risk of higher levels, other factors may also raise your risk. People with African or South Asian heritage may have higher Lp(a) levels, but post-menopause, diabetes, and chronic kidney disease may also lead to increased levels.
If you have any risk factors for heart disease or high Lp(a), your doctor may request a special test for Lp(a). People with familial hypercholesterolemia, a genetic condition that results in an unusually high buildup of LDL cholesterol, may also be checked for high Lp(a). Unlike a routine cholesterol test, cardiologists tell NBC News that only a single Lp(a) test is needed because these levels typically remain stable.
While adopting healthy habits can help lower high cholesterol, they don’t affect Lp(a) levels. However, that doesn’t mean you don’t have options. Lifestyle changes can lower your risk of heart disease, such as managing your LDL cholesterol and weight, eating a healthy diet, and regular exercise. It also helps to limit alcohol consumption and quit smoking.
Medications on the horizon to treat Lp(a)
To help reduce your risk of complications due to high Lp(a) levels, your doctor may recommend taking aspirin, a statin, or a PCSK9 inhibitor to help lower LDL cholesterol (here are some side effects of cholesterol medications). Clinical trials for drugs to specifically lower Lp(a) are also underway. According to WebMD, five medications are currently being developed.
Ionis Pharmaceuticals has developed pelacarsen, which was found to be safe and effective in lowering Lp(a) in earlier clinical trials. A 2023 article in the Journal of Clinical Lipidology reported that a single dose of pelacarsen can reduce Lp(a) by as much as 74%, depending on the dosage. Novartis Pharmaceuticals has licensed the drug, with results from its phase 3 clinical trials expected this year.
Eli Lilly and Company’s phase 2 trial of lepodisiran was found to reduce Lp(a) by 94% at its highest dosage after 60 and 180 days, according to a 2025 study in the New England Journal of Medicine. Even the lowest dose of lepodisiran showed a 41% drop in Lp(a). The company is currently enrolling participants in its phase 3 trials. The results of Amgen’s phase 2 trial on olpasiran were published in a 2024 article in the Journal of the American College of Cardiology. Olpasiran’s highest dosage reduced Lp(a) by 84% and maintained those levels for about a year after treatment.
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