What if your cholesterol numbers look perfectly normal, but you’re still at risk for a heart attack or stroke? For years, doctors have relied on standard cholesterol tests to assess cardiovascular health. These tests measure LDL, often called “bad” cholesterol, HDL or “good” cholesterol, and triglycerides. But there’s another important marker that most people have never heard of: lipoprotein(a), or Lp(a).
And it’s getting national attention.
In a recent article published by Harvard Health Publishing,medical experts explain why new cholesterol guidelines recommend that all adults undergo Lp(a) testing at least once in their lifetime. The surprising part? You can have healthy cholesterol numbers and still have elevated Lp(a).
What’s the Difference Between LDL and Lp(a)?
LDL cholesterol contributes to plaque buildup in the arteries, increasing the risk of cardiovascular disease. Lp(a) is an LDL-like particle with an additional protein called apolipoprotein(a). Elevated levels are associated with plaque buildup in the arteries and an increased risk of cardiovascular disease.
Dr. Mary Van, clinical director of ThriveX Medical in Fort Lauderdale, says patients need to understand the distinction between LDL and Lp(a), which she considers an especially important cardiovascular risk marker.
“Lp(a) is actually more likely to cause atherosclerosis and what we associate with blood clots than LDL is,” she says.
Both LDL and Lp(a) are important cardiovascular risk factors, and having elevated Lp(a) makes managing LDL cholesterol even more important. Unlike LDL, which can be influenced by diet, exercise and medication, Lp(a) levels are largely inherited.
According to Harvard Health, approximately one in five people has elevated Lp(a) levels. A level of 125 nanomoles per liter or higher is associated with approximately 40% greater relative risk of cardiovascular disease compared with people who have lower Lp(a) levels.
Why Is Everyone Talking About Lp(a) Now?
The issue is moving beyond medical journals and into mainstream conversations about preventive health.
In August 2026, The Washington Post published an article examining what an Lp(a) test can reveal about heart health, reflecting growing public interest in this often-overlooked cardiovascular risk factor.
The renewed attention comes as medical organizations encourage earlier identification of inherited heart disease risks.
For Dr. Van, testing younger adults is particularly important because it can help identify inherited risks before cardiovascular problems develop. “We need to know you have that genetic predisposition,” she explains.
The latest guidelines recommend that all adults have their Lp(a) levels checked at least once, regardless of age.
What About Hormones and Menopause?
While genetics are the primary driver of Lp(a), hormonal changes may also influence cardiovascular health, particularly during perimenopause and menopause. Dr. Van encourages women to pay attention to these changes as they age, especially as estrogen levels begin to decline.
“After you start hitting menopause, the perimenopause, then you get the Lp(a) levels tested, because it can be impacted by hormonal imbalances,” she says.
Research suggests Lp(a) levels may rise after menopause, although genetics remain the primary determining factor. Because Lp(a) levels are generally stable throughout adulthood, repeat testing is not routinely necessary. However, additional testing may be appropriate in certain circumstances.
Hormone replacement therapy is not an established treatment specifically for lowering Lp(a) or preventing cardiovascular events.
What Happens if Your Lp(a) Is High?
Elevated Lp(a) doesn’t mean a heart attack is inevitable. It means understanding and managing your overall cardiovascular risk becomes especially important.
Although healthy eating, exercise and weight management generally have little direct effect on genetically elevated Lp(a), they remain essential for protecting your heart.
Harvard Health notes that physicians may recommend more aggressive management of other risk factors, including LDL cholesterol, blood pressure and smoking.
Should You Get Tested?
If you’ve never had an Lp(a) test, now is a good time to ask your healthcare provider about one. A simple blood test can reveal information that a standard cholesterol panel misses.
At ThriveX Medical, Dr. Van emphasizes personalized care and looking beyond routine lab results to better understand each patient’s health.
Want to learn more about your cardiovascular risk? Call ThriveX to schedule a consultation.