The genetic risk factor that many men overlook
Lipoprotein(a) , or Lp(a), is a genetically determined fat particle in the blood that is structurally similar to LDL cholesterol but contains additional factors influencing vascular health and coagulation. Approximately 20–30% of the world's population has elevated levels, regardless of diet, exercise, or other risk factors. High Lp(a) levels are considered an independent risk factor for heart attack, stroke, aortic valve calcification, and peripheral vascular disease .
Lp(a) tends to accumulate in atherosclerotic plaques and increases the tendency towards inflammation and coagulation - especially in men with a family history or early cardiovascular disease.
Since Lp(a) levels are largely genetically determined, they hardly change with lifestyle. Nevertheless, knowing the value is crucial – not to cause panic, but for targeted prevention and risk assessment.
Typical values and meaning
- < 30 mg/dL (< 75 nmol/L) - low risk
- 30–50 mg/dL (75–125 nmol/L) – moderately elevated, to be monitored depending on other risk factors
- ≥ 50 mg/dL (125 nmol/L) - clearly increased risk of cardiovascular disease
These limit values are guidelines - in individual cases, the specific risk profile may be relevant even with moderate Lp(a).
Why Lp(a) is important for men
Many men feel healthy but still have elevated Lp(a) levels – often they don't recognize the connection. As a result, the risk only becomes apparent after a heart attack or stroke.
Lp(a) particularly increases:
- the risk of vascular occlusions and clot formation
- the progression of arteriosclerosis
- the risk of aortic valve calcification
- the risk of cardiovascular events despite supposedly "normal" cholesterol levels
A positive finding does not necessarily mean that treatment is needed, but it helps to be more aware of the burden caused by LDL, inflammation and metabolic disorders.
Diagnosis and evaluation of Lp(a)
A simple blood test provides the Lp(a) level. Since it is genetically determined, a single measurement is often sufficient – especially if no significant fluctuations due to lifestyle changes are expected.
Recommendations:
- Lp(a) in familial heart disease or early heart attacks
- Lp(a) measurement in cases of elevated LDL, lipid profile or risk despite a healthy lifestyle
- Interpretation in the context of other markers such as LDL, HDL, ApoB, CRP
What to do if Lp(a) levels are elevated?
Since the mirror is not directly influenced by diet or exercise, other strategies are more important:
- Control and, if necessary, reduction of LDL and triglycerides
- Reduction of inflammation (measurable, for example, via the CRP level)
- Monitoring of blood pressure, blood sugar, insulin sensitivity
- For very high risk: Lipid apheresis (covered by law in selected cases)
- Future: clinical trials on drug-based Lp(a) lowering are pending.
Conclusion
Lp(a) is a genetic risk marker that is of considerable importance for men – especially in combination with other risk factors. An elevated level does not necessarily mean disease, but it does offer opportunities for prevention: awareness, monitoring of other lipid and inflammation markers, and targeted medical support.
Tip: In the podcast episode "What Your Blood Values Really Mean," Dr. Jonathan Apasu and Dr. Helena Orfanos-Böckel analyze a comprehensive blood test, including lipid profiles, ApoB, and Lp(a). The episode impressively demonstrates how precise diagnostics and individual interpretation go hand in hand—even when one's lifestyle appears perfect.
A measurement of the LP(a) value is possible at your family doctor's office, at a direct laboratory, or via our Comprehensive Health Check for home use .
