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Cardiovascular · Reference range

Lp(a)

Also reported as: Lipoprotein(a) · Lp little a

An LDL-like particle carrying an additional apolipoprotein(a) tail. Blood level is roughly 90% genetically determined and stable across life.

Lab reference range
< 75 nmol/L

Reporting units differ between labs — nmol/L and mg/dL are not interchangeable, and the conversion between them is approximate.

Optimal target
< 75 nmol/L

Below 75 nmol/L (about 30 mg/dL) is the widely used desirable threshold; above 125 nmol/L is treated as a clear risk enhancer.

Guideline thresholds from: European Atherosclerosis Society consensus statement

To convert to mg/dL, multiply by 0.4.

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Where the thresholds sit

BandRange (nmol/L)Note
Desirable< 75
Borderline75–125
High risk125–250
Very high risk> 250

Why it matters

Elevated Lp(a) is an independent, largely inherited risk factor affecting roughly one adult in five, and it is invisible on a standard lipid panel. Because it barely moves with diet or exercise, its value is in risk stratification: a high Lp(a) is the argument for treating every other modifiable risk factor more aggressively.

What raises it

  • Genetics — the LPA gene sets roughly 90% of the level
  • Kidney disease
  • Hypothyroidism
  • Post-menopause, modestly

What lowers it

  • Niacin and PCSK9 inhibitors, modestly
  • Apheresis, in severe familial cases
  • Investigational antisense and siRNA therapies now in outcome trials

How to move it

  1. 1Test it once. It is stable for life, so a single measurement in adulthood is usually enough.
  2. 2If it is high, the response is not to chase Lp(a) itself but to drive ApoB substantially lower and control blood pressure tightly.
  3. 3Tell first-degree relatives — it is inherited, and they will not know unless someone tests.
  4. 4Do not add niacin on your own for this; the outcome data do not support it despite the Lp(a) reduction.

What moves this marker

Interventions on this site with evidence behind them for this specific marker. None of them replaces working out why yours is where it is.

What makes a single reading misleading

  • mg/dL and nmol/L conversions are approximate because particle size varies between people.
  • Levels rise transiently with acute inflammation.
  • A normal Lp(a) does not offset a high ApoB — they are separate risks.

Sources

Read next

Interpret your whole panelAll biomarkers

Educational only. Reference ranges are not diagnostic thresholds and this page cannot account for your medical history, medication or symptoms. Discuss any result that concerns you with a qualified clinician. See our medical disclaimer.