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Lipoprotein (a) Blood Test
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Lab Tests

Lipoprotein (a) Blood Test

A lipoprotein (a) blood test measures a specific type of "bad" cholesterol to help determine your risk for heart disease, stroke, and arterial blockages.

What is a lipoprotein (a) blood test?

A lipoprotein (a) test measures the level of lipoprotein (a) in your blood. Lipoproteins are particles made of protein and fats that carry cholesterol through the bloodstream. Lipoprotein (a) is a type of LDL ("bad") cholesterol.

Because these particles are "stickier" than other LDL particles, they are more likely to cause blockages and blood clots in your arteries. This can lead to atherosclerosis, or "hardening of the arteries," which may result in:

  • Coronary artery disease
  • Heart attack
  • Stroke
  • Peripheral arterial disease
  • Other blood vessel diseases

This test provides a more accurate risk assessment than a routine cholesterol test, as your total LDL level might appear healthy even if a large percentage of that cholesterol is carried by high-risk lipoprotein (a) particles.

Why do I need a lipoprotein (a) test?

This is not a routine screening test. It is typically ordered if you have a high risk for arterial blockages, such as:

  • A family history of early heart or blood vessel disease.
  • High LDL cholesterol that does not respond to medication.
  • Heart or blood vessel disease despite having normal cholesterol and triglyceride levels.
  • Signs of familial hypercholesterolemia.
  • History of multiple heart attacks or angioplasties.

What happens during a lipoprotein (a) test?

A health care professional will take a blood sample from a vein in your arm using a small needle. The process usually takes less than five minutes.

Preparation and Results

You may need to fast for 9 to 12 hours before the test. Inform your provider if you consume alcohol or take niacin supplements, aspirin, or oral estrogen hormones, as these can affect results.

Because your genes control your lipoprotein (a) levels, they generally remain stable throughout your life and are not typically changed by diet or exercise. However, if your levels are high, your provider may recommend steps to improve overall heart health, such as:

  • Taking medication to lower LDL cholesterol.
  • Eating a healthy diet and losing weight.
  • Quitting smoking and getting regular exercise.
  • Reducing stress and lowering blood pressure.

Frequently Asked Questions

If Lp(a) is elevated, clinicians may add or intensify therapies such as statins, PCSK9 inhibitors, or inclisiran, and emphasize strict blood pressure control, smoking cessation, and lifestyle changes. Some patients may also be considered for novel Lp(a)-lowering agents in clinical trials.
Lipoprotein(a) is a distinct particle that can drive atherosclerosis even when total LDL appears controlled. A high Lp(a) level indicates a genetic risk for heart disease, stroke, or peripheral artery disease that standard lipid panels may miss, prompting more aggressive prevention.
Most laboratories recommend fasting for 9–12 hours before the test because triglyceride levels can affect the assay. However, some newer tests are fasting‑independent; confirm the requirement with your lab.
Evidence is limited, but maintaining a healthy weight, engaging in regular aerobic exercise, limiting saturated fats, and avoiding excess alcohol may modestly reduce Lp(a). Certain supplements like niacin have shown some effect, but they should only be used under medical supervision.===
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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