Cardiovascular risk assessment is evolving — and one marker getting renewed attention is lipoprotein(a), also called Lp(a). Despite decades of research, misunderstanding remains common. A recent article from Healio highlights eight myths about Lp(a) that continue to circulate in cardiology circles and among patients alike.
Below, we break down these misconceptions and explain why Lp(a) deserves a place in modern cardiovascular screening.
What Is Lipoprotein(a) — and Why It Matters
Lipoprotein(a), pronounced “Lp little a,” is a variant of LDL (“bad”) cholesterol that contains an additional protein known as apolipoprotein(a). Elevated levels of Lp(a) are primarily inherited, meaning they are determined by genetics rather than lifestyle. Research shows that high Lp(a) levels can significantly increase the risk of atherosclerosis, heart attack, and stroke — even when traditional cholesterol levels appear normal.
Because Lp(a) levels remain stable throughout life, testing once is often enough to identify elevated risk. That makes it a uniquely valuable marker for early detection and prevention strategies.
Eight Common Myths About Lp(a) — and the Truth Behind Them
1. Myth: Only high-risk patients need Lp(a) testing
Reality: Lp(a) elevation is genetic and often silent, which means even individuals without obvious cardiovascular risk factors may have elevated levels. Experts recommend everyone be tested at least once in adulthood to uncover potential inherited risk. Detecting elevated Lp(a) early can guide preventive strategies long before symptoms develop.
2. Myth: Lp(a) levels fluctuate widely over time
Reality: Unlike other cholesterol markers, Lp(a) remains relatively constant throughout life. Because your genetic makeup determines your level, it doesn’t typically respond to diet, weight loss, or exercise. This stability actually makes Lp(a) a powerful biomarker — a single test can reliably represent your lifetime level and associated risk.
3. Myth: Statins and diet can lower Lp(a)
Reality: Traditional cholesterol-lowering methods like statins or dietary adjustments have little to no effect on Lp(a). In some cases, statins may even slightly raise Lp(a) levels. That doesn’t mean treatment is futile — rather, it emphasizes the need to control all other modifiable risk factors while keeping an eye on emerging targeted therapies currently in clinical trials.
4. Myth: Normal LDL levels mean Lp(a) doesn’t matter
Reality: You can have perfectly normal LDL cholesterol and still face elevated cardiovascular risk if your Lp(a) is high. Studies show that Lp(a) contributes independently to plaque buildup and arterial inflammation. In other words, LDL and Lp(a) risks stack — they don’t cancel each other out.
5. Myth: High Lp(a) is only a concern in older adults
Reality: Since elevated Lp(a) is present from birth, its effects can accumulate over decades. Younger individuals with elevated levels may be at risk for premature heart disease or stroke. Early identification allows clinicians to start prevention earlier — potentially decades before symptoms or events occur.
6. Myth: No treatments exist for high Lp(a)
Reality: While traditional options are limited, there is exciting progress in novel therapies specifically designed to target Lp(a). PCSK9 inhibitors can modestly reduce Lp(a) levels, and several antisense oligonucleotide therapies are in late-stage trials showing promise for major reductions. Within a few years, Lp(a)-lowering medications could become part of standard care.
7. Myth: High Lp(a) always requires aggressive intervention
Reality: Elevated Lp(a) levels should be interpreted in context. Not everyone with high Lp(a) needs advanced medication. For many patients, focusing on controlling blood pressure, blood sugar, LDL cholesterol, and lifestyle factors can substantially reduce overall cardiovascular risk. Treatment decisions should always be individualized.
8. Myth: Lp(a) isn’t actionable today
Reality: This is perhaps the most persistent misconception. Even without an FDA-approved Lp(a)-specific drug, Lp(a) information is actionable right now. Knowing your level allows physicians to personalize prevention strategies — from more frequent screening to earlier use of proven interventions. As one expert at the American Society for Preventive Cardiology Congress noted, “evaluation and management of Lp(a) is actionable today.”
What This Means for Patients and Clinicians
The message is clear: Lp(a) testing matters.
- Early detection empowers prevention. A one-time blood test can reveal lifetime genetic risk and help clinicians fine-tune cardiovascular care.
- Management starts with what we can control. Even if Lp(a) can’t yet be lowered directly, optimizing LDL cholesterol, blood pressure, blood sugar, and inflammation remains critical.
- Emerging therapies are on the horizon. Ongoing trials of Lp(a)-lowering agents are advancing quickly, potentially offering targeted treatments within the next few years.
- Patient awareness drives better outcomes. Knowing your Lp(a) status can help you and your doctor take proactive steps to reduce long-term risk.
Why UDS Health Is Paying Attention
At UDS Health, we’re committed to early detection and proactive cardiovascular care. As science continues to evolve, integrating Lp(a) screening into comprehensive heart evaluations could help clinicians identify high-risk individuals before disease develops.
If you’ve never had your Lp(a) checked — especially if you have a family history of early heart disease — it may be time to discuss it with your provider. Knowledge of your genetic risk can inform a lifetime of heart-healthy decisions.
Source: Healio. “Eight Lp(a) Myths Debunked.” August 12, 2025.
