Biomarkers: Lp(a) — The Cardiovascular Risk Factor You Were Born With

Most cardiovascular risk factors respond to lifestyle. Lp(a) is different — and that's exactly why you need to know your number.

Lipoprotein(a) — written Lp(a) and pronounced "L-P-little-a" — is a type of LDL-like particle with an additional protein (apolipoprotein(a)) attached. That extra protein makes it stickier, more inflammatory, and more atherogenic than regular LDL. High Lp(a) is one of the most potent genetic risk factors for cardiovascular disease, heart attack, and stroke.

Why It's Largely Genetic

Unlike LDL or triglycerides, Lp(a) is determined almost entirely by genetics — specifically by the LPA gene. Diet, exercise, weight loss, and statins have little to no effect on Lp(a) levels. If your Lp(a) is high, it's been high since birth, and it will stay roughly constant throughout your life.

This is not a reason for fatalism. It's a reason for awareness.

Who Should Be Most Concerned

Lp(a) levels vary enormously between individuals and between ethnic groups. People of African descent tend to have higher Lp(a) levels on average; East Asian populations tend to have lower levels. Around 20–25% of the global population carries Lp(a) levels considered elevated.

The risk is not linear — very high Lp(a) (above 75–100 nmol/L) confers substantially elevated risk, particularly when combined with other risk factors. At these levels, more aggressive management of all the modifiable risk factors — LDL, blood pressure, blood sugar, smoking — becomes more important than it would otherwise be.

Why You Only Need to Test Once

Because Lp(a) doesn't change with lifestyle, there's no value in repeated testing. Most clinical guidelines — including the European Society of Cardiology — recommend testing once, ideally in early adulthood, and using the result to calibrate how aggressively you manage the modifiable risk factors.

The app records your Lp(a) and marks it as a once-tested marker.

What to Do If Your Lp(a) Is High

Manage everything else more aggressively: If you have high Lp(a), your margin for error on LDL, blood pressure, blood sugar, and inflammation is smaller. These are all addressable. Treat them with proportionally more urgency.

Know your family history: High Lp(a) clusters in families. If you have a parent or sibling who had a heart attack before 60, Lp(a) may well be part of the story.

Emerging treatments: Several drugs targeting Lp(a) directly are in late-stage clinical trials as of 2026. None are yet approved for general use, but this is a fast-moving area. If your Lp(a) is very high, a cardiologist with an interest in this space is worth consulting.

We are not doctors. Discuss your Lp(a) result and its implications with a healthcare professional.

The 100 Great Years perspective

Lp(a) is unusual among longevity biomarkers: knowing your number does not give you a lever to pull. It gives you a level of awareness that changes how urgently you manage everything else. If you carry high Lp(a), the modifiable risk factors — LDL, blood pressure, inflammation, blood sugar — demand more attention, not less. 100 Great Years is built on the idea that knowledge is the foundation of action. Lp(a) is knowledge that most people in their 30s and 40s have never been given. That changes now.

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This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making decisions about your health.