Blood draw
Lipoprotein(a) (Lp(a))
Lipoprotein(a); hereditary risk factor for cardiovascular diseases.
€ 35,00
All tests
Heart and vessels · Blood
Lipoprotein(a)
An inherited cholesterol particle that raises the risk of cardiovascular disease independently of LDL; one measurement is usually enough.
At a glance
- Measured in blood
- In 4 test panels
- No special preparation
Explanation
Lipoprotein(a): what is measured?
Lipoprotein(a), Lp(a) for short, is an LDL particle with an extra protein attached to it: apolipoprotein(a). Like LDL, it can deposit cholesterol in the blood vessel wall and so contribute to hardening of the arteries (atherosclerosis). About 90 percent of the amount of Lp(a) in the blood is fixed by your genes, and it barely changes from adulthood onward. Lifestyle has little influence on it, and the standard lipid profile does not measure Lp(a) separately.
What can it detect?
- Inherited raised Lp(a), a risk factor for cardiovascular disease that is independent of LDL cholesterol
- A possible explanation for cardiovascular disease at a young age in yourself or in your family
- An extra risk factor in familial hypercholesterolemia (inherited high cholesterol)
Result
What does the result mean?
Lipoprotein(a) too high
A raised Lp(a) fits a higher risk of a heart attack, a stroke and narrowing of the arteries. The Dutch guidelines consider a value above 50 mg/dl raised; this applies to about 1 in 5 people. How large the extra risk is exactly is hard to say for one person and depends strongly on the other risk factors, such as smoking, blood pressure and LDL cholesterol. A high value is almost always inborn; kidney disease can also raise the value. A high Lp(a) does not cause symptoms.
Lipoprotein(a) too low
A low Lp(a) is favorable and common; it means this particle contributes little to your risk. It says nothing about the other risk factors: a high LDL cholesterol, smoking or high blood pressure weigh just as heavily. A low value has no downsides and causes no symptoms.
After an abnormal result
With a raised value, the GP assesses the full risk profile (blood pressure, smoking, LDL cholesterol, diabetes), and the approach focuses on lifestyle and, if needed, on a lower LDL cholesterol. With cardiovascular disease at a young age or inherited high cholesterol in the family, referral to an internist (specialist in internal medicine) may follow, who can take Lp(a) into account in treatment according to the guideline on hereditary dyslipidemia.
Reliability
How reliable is the test?
Lp(a) is a risk marker, not a test that shows a disease. According to the guideline on laboratory diagnostics, one measurement is enough because the value stays virtually the same for life, and you do not need to be fasting. According to the Dutch guideline on hereditary dyslipidemia, Lp(a) is most informative with unexplained cardiovascular disease at a young age, in yourself or in your family, with inherited high cholesterol and with recurring cardiovascular disease despite treatment. Lp(a) is not part of the SCORE2 risk estimate in the Dutch GP guideline (NHG) on cardiovascular risk management. A recent European guideline (ESC/EAS 2025) advises measuring Lp(a) at least once in your life.
What can affect the result?
- Laboratories report Lp(a) in mg/dl or in nmol/l; converting between these units is unreliable, so only compare results in the same unit and preferably from the same laboratory.
- The cutoff of 50 mg/dl is based on research in people of European descent; there are no good normal values for people of other descent.
- In kidney disease the value can come out higher; the laboratory and the doctor take this into account when assessing it.
- There is no research yet showing that specifically lowering Lp(a) prevents cardiovascular disease; the result therefore mainly directs attention to the other risk factors.
Who it is for
Who is the test useful for?
Useful for
According to the Dutch guideline, mainly useful after a heart attack, stroke or narrowing of the arteries at a young age without a clear cause, in yourself or in close relatives, with inherited high cholesterol and with a known high Lp(a) in the family. Once you have been measured, you do not need to repeat the test. In people without symptoms and without a family history, the result usually does not change the advice, because there is no targeted treatment yet and the approach focuses on the other risk factors.
How common is it?
Because 50 mg/dl roughly corresponds to the highest 20 percent of the population, about 1 in 5 adults has a raised Lp(a). It is passed on through families: children, brothers and sisters of someone with a high Lp(a) are more likely to have a high value. In 2024, more than 1.7 million people in the Netherlands were known to have a cardiovascular disease.
Dutch medical specialists' guidelines (FMS) on hereditary dyslipidemia and CVRM (80th percentile); VZinfo (RIVM), 2024
Drawbacks and risks
- A high value cannot be changed with lifestyle and there is no targeted treatment yet; this can cause worry without anything that can be done about it directly.
- There is no uniform Dutch advice on what to do with a raised Lp(a); the advice can therefore differ between healthcare providers.
Get tested
Lipoprotein(a): test panels
Lipoprotein(a) is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Blood draw
Cardio Profile Extensive
Complete lipids, Lipoprotein(a), Apolipoprotein B/A1, kidney function and blood sugar. Advanced cardiovascular risk analysis.
€ 165,00
Blood draw
Whoop (Advanced Labs)
Comprehensive blood analysis with biomarkers that integrates directly with your WHOOP wearable for optimal performance and recovery.
€ 385,00
Fingerstick
Lipoprotein(a) (Lp(a)) (finger-prick)
Lp(a); a largely inherited marker of cardiovascular risk.
€ 35,00
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and results- FMS Richtlijnendatabase, richtlijn Erfelijke dyslipidemie in de 2e en 3e lijn: Meten Lp(a)
- FMS Richtlijnendatabase, richtlijn Erfelijke dyslipidemie in de 2e en 3e lijn: Behandeling patiënten met verhoogd Lp(a)
- FMS Richtlijnendatabase, richtlijn Laboratoriumtechnische aspecten bij lipidendiagnostiek: Pre-analytische aspecten
- FMS Richtlijnendatabase, richtlijn CVRM: Nuchter bloedprikken bij CVRM
- NHG-Standaard Cardiovasculair risicomanagement (M84)
More explanations
Other tests: Heart and vessels
- Apo B/A1 ratio
- Apolipoprotein A1
- Apolipoprotein A2
- Apolipoprotein B
- Cholesterol, total
- Cholesterol/HDL ratio
- DHA
- EPA
- HDL cholesterol
- HDL-LDL risk index
- Homocysteine
- LDL cholesterol