There's a cardiovascular risk factor that's entirely genetic, affects roughly 20% of the population, can't be detected by a standard lipid panel, and most people have never been tested for it.
It's called Lipoprotein(a), written as Lp(a) and pronounced "L-P-little-A."
Unlike cholesterol levels, which can be influenced by diet, exercise, and medication, Lp(a) is almost entirely determined by your genes. Your level is set. It doesn't change meaningfully with lifestyle. And if it's elevated, it increases your risk of cardiovascular disease independent of everything else on your lipid panel.
The good news: you only need to test it once.
What Lp(a) Is
Lp(a) is a type of lipoprotein particle, similar to LDL, but with an additional protein called apolipoprotein(a) attached. This extra protein makes it more dangerous: it promotes plaque buildup more aggressively, promotes blood clotting, and promotes inflammation in the arterial wall.
Why Most People Haven't Been Tested
Lp(a) testing is not part of any standard lipid panel in Canada. Your doctor doesn't include it in routine blood work. Under OHIP, there needs to be a specific clinical indication.
What's a High Lp(a) Level?
- Normal: below 75 nmol/L
- Elevated: 75-125 nmol/L
- High: above 125 nmol/L
About 20% of the global population has Lp(a) levels above 125 nmol/L. Your level doesn't change with diet, exercise, or standard cholesterol-lowering medications. Testing it once gives you the number for life.
What to Do If Your Lp(a) Is Elevated
If your Lp(a) comes back high, it doesn't mean a heart attack is inevitable. It means you have an additional risk factor that should be managed alongside the ones you can control: keeping ApoB low, managing blood pressure, metabolic health, and inflammation. Several pharmaceutical companies are developing Lp(a)-lowering therapies currently in late-stage clinical trials.
How to Get Lp(a) Tested
You can order an Lp(a) test through Bespoke Labs. Consider pairing it with ApoB and a full lipid panel for a complete cardiovascular risk picture. Walk into any Dynacare location in Ontario. No appointment needed. Test it once. If it's normal, you're done. If it's elevated, you have information that could shape your cardiovascular strategy for decades.