My Lp(a) Is High, but I Can't Change It With Diet. So What's the Point of Knowing?

What Is Lipoprotein(a)?

Lipoprotein(a), or Lp(a), is a cholesterol-carrying particle similar to LDL, with an extra protein attached. High levels increase the risk of heart attack, stroke, and narrowing of the aortic valve.

Lp(a) is about 90% determined by genetics. It's largely set from early childhood, and diet and exercise have little effect on it. About 1 in 5 people have elevated levels—most without knowing it.

Why Test If You Can't Change It?

Knowing your Lp(a) is still very valuable:

• It changes how aggressively you manage other risks. If your Lp(a) is high, keeping LDL/ApoB, blood pressure, and blood sugar well controlled becomes even more important
• It may influence treatment decisions. A high Lp(a) can tip the balance toward starting a statin or other cholesterol-lowering medication
• It explains family history. If heart disease runs in your family despite healthy habits, Lp(a) may be the reason
• It helps your family. Because it's inherited, relatives may want to get tested too
• You only need to test once for most people, since levels stay fairly stable

Many guidelines now recommend that every adult check Lp(a) at least once.

What About Treatments?

There's currently no FDA-approved medication specifically for lowering Lp(a). Several drugs that dramatically lower Lp(a) have been in development. In 2026, the first large outcome trial of one of these drugs, pelacarsen, reported that it lowered Lp(a) substantially but did not significantly reduce cardiovascular events in the main analysis. Other Lp(a)-lowering drugs are still being studied, so the picture may continue to evolve.

For people with very high Lp(a) and heart disease, a procedure called lipoprotein apheresis is sometimes used. Some cholesterol medications, like PCSK9 inhibitors, modestly lower Lp(a) as well.

What You Can Do Now

• Keep LDL cholesterol and ApoB low
• Don't smoke
• Control blood pressure and blood sugar
• Stay active and maintain a healthy weight
• Work with a provider on a personalized prevention plan

Learn more about advanced lab testing here: Heva Lab Testing

The Bottom Line

You can't change your Lp(a) much with lifestyle, but knowing it helps you and your provider manage your overall heart risk more aggressively—and alerts your family to theirs.