Lipoprotein(a)nmol/L
Genetic CVD risk factor
Also known as: Lp(a)
Typical optimal range
0–75 nmol/L
A level below 75 nmol/L is generally considered within the optimal range, though reference ranges can vary between laboratories, so always interpret your result alongside your own lab's guidance. These figures are indicative — the range printed on your own lab report is the definitive one for your results.
Lp(a) testing and interpretation in the UK is informed by the HEART UK consensus statement on Lp(a) and by NICE guideline NG238 on cardiovascular risk assessment and lipid management.
What is Lipoprotein(a)?
Lipoprotein(a) — usually written as Lp(a) — is a particle that closely resembles LDL cholesterol but carries an extra protein called apolipoprotein(a) attached to it. Its levels in the blood are almost entirely determined by genetics, meaning they are set largely from birth and remain stable throughout adult life. Measuring Lp(a) is useful because elevated levels are an independent risk factor for heart attack, stroke, and aortic valve disease — a risk that sits on top of, and separate from, conventional cholesterol levels.
What a high Lipoprotein(a) means
A raised Lp(a) is not a diagnosis of heart disease, but it is a signal that your lifetime cardiovascular risk may be higher than standard cholesterol tests alone would suggest — and that careful management of every other modifiable risk factor becomes especially worthwhile.
- Genetics. Lp(a) levels are up to 90% heritable and driven primarily by variations in the LPA gene. If a close family member has high Lp(a) or premature cardiovascular disease, there is a meaningful chance you may share this trait.
- Ethnicity. People of South Asian descent tend to have higher average Lp(a) levels than those of European descent, which may contribute to the elevated cardiovascular risk seen in this population. This is an inherited biological pattern rather than a lifestyle effect.
- Hormonal changes. Lp(a) levels can rise after the menopause in some women, possibly due to falling oestrogen levels. This is one reason cardiovascular risk increases for women after midlife and is worth discussing with a GP if other risk factors are also present.
Unlike most lipid markers, Lp(a) is not meaningfully raised or lowered by diet, exercise, or standard lipid-lowering therapies such as statins — the reading largely reflects your genetic baseline, which is why it only needs to be measured once in most adults.
What a low Lipoprotein(a) means
A low Lp(a) level is generally considered favourable and is not clinically significant — it simply means this particular genetic risk factor is unlikely to be contributing to your cardiovascular risk.
Should I be worried?
Because Lp(a) is genetically determined, a single measurement is generally sufficient — levels rarely change substantially over time, so repeat testing is not usually needed. If your result is above the optimal range, the priority is not to panic but to have a conversation with your GP about your overall cardiovascular risk picture. They may want to review your blood pressure, standard lipid panel, blood glucose, and family history, and may consider whether a more formal cardiovascular risk assessment is appropriate. For people with very high Lp(a) alongside other risk factors or a family history of early heart disease, referral to a lipid clinic is sometimes recommended. Emerging treatments specifically targeting Lp(a) are in late-stage clinical trials but are not yet widely available on the NHS.
What actually helps
Because Lp(a) itself is largely resistant to lifestyle change, the evidence-based approach is to focus on reducing every other cardiovascular risk factor as aggressively as possible.
- Manage LDL cholesterol. Statins and other lipid-lowering therapies do not substantially reduce Lp(a), but lowering LDL cholesterol is still one of the most effective steps you can take to reduce overall cardiovascular risk when Lp(a) is elevated.
- Control blood pressure. High blood pressure compounds the vessel damage that elevated Lp(a) can promote. Keeping blood pressure within a healthy range — through lifestyle and medication if needed — is a key protective step.
- Stop smoking. Smoking is a major independent cardiovascular risk factor, and its combined effect with high Lp(a) is particularly harmful. Stopping smoking is the single most impactful modifiable change most people can make.
- Stay physically active. Regular aerobic exercise supports cardiovascular health broadly — improving blood pressure, blood glucose, HDL cholesterol, and vascular function — even though it does not directly lower Lp(a) itself.
While no foods reliably lower Lp(a), a heart-healthy dietary pattern supports the overall cardiovascular risk reduction that is so important when Lp(a) is raised.
Oily fish (salmon, mackerel, sardines)
Rich in omega-3 fatty acids, which have good evidence for reducing triglycerides and supporting cardiovascular health more broadly.
Oats and barley
Contain beta-glucan soluble fibre, which has strong evidence for lowering LDL cholesterol — an important target when Lp(a) cannot itself be reduced.
Fruits and vegetables
High intake is consistently associated with lower cardiovascular risk in large population studies, likely through multiple mechanisms including blood pressure and inflammation.
Nuts (especially walnuts and almonds)
Associated with improvements in LDL cholesterol and overall cardiovascular risk markers in well-replicated clinical trials.
Legumes (lentils, beans, chickpeas)
Provide soluble fibre and plant protein, both linked to modest reductions in LDL cholesterol and improved cardiometabolic markers.
Olive oil (extra virgin)
A cornerstone of the Mediterranean diet, which has strong evidence for cardiovascular benefit; its monounsaturated fats support a favourable lipid profile.
Track your own Lipoprotein(a)
Upload a lab PDF and Better Days trends Lipoprotein(a) over time, flags it when it drifts, and suggests foods that help.
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Sources & further reading
These are reputable UK health resources for further reading. This page is written to be consistent with their guidance but is not a substitute for them.
For information only — not medical advice, and not individually reviewed by a clinician. Reference ranges vary by lab and individual. Discuss any results with a qualified clinician before making changes.