Most people have never heard of it — including many doctors

Lipoprotein(a), written as Lp(a) and pronounced “LP little a,” is a type of cholesterol particle that significantly raises the risk of heart attack, stroke, and peripheral artery disease. It’s been known to researchers for decades.

And yet most patients have never had their Lp(a) tested. Many primary care physicians don’t routinely order the test. Even cardiologists sometimes overlook it — partly because treatment options have historically been limited, and partly because it simply isn’t on most standard cholesterol panels.

If you’ve had a heart attack, stroke, or early cardiovascular disease — especially with a family history — and nobody has mentioned Lp(a), it’s worth asking your doctor for a test.

It’s completely genetic. Diet won’t fix it.

Unlike LDL cholesterol — which is influenced by what you eat, how much you exercise, and your weight — Lp(a) is determined almost entirely by the genes you were born with. Between 70% and 90% of your Lp(a) level is set at birth and stays relatively constant throughout your life.

Because it’s genetic, Lp(a) tends to run in families. If you have elevated Lp(a), your children and siblings have a significantly higher chance of having it too. First-degree relatives should be tested.

It’s not on your standard cholesterol test

When your doctor orders a “lipid panel,” it measures your total cholesterol, LDL, HDL, and triglycerides. Lp(a) is not included — it requires a separate blood draw specifically ordered for Lp(a).

There’s an important technical wrinkle: Lp(a) cholesterol is actually counted inside your LDL number. This means two patients with identical LDL readings of 100 mg/dL could have very different heart disease risks — if one has high Lp(a) and the other doesn’t.

It raises your risk even if everything else looks normal

This is perhaps the most important thing to understand about Lp(a): it is an independent risk factor. That means it raises your risk of cardiovascular disease even if your LDL is normal, your blood pressure is controlled, and you don’t smoke.

Lp(a) particles are stickier than regular LDL. They promote plaque buildup in the arteries, contribute to clot formation, and drive inflammation in blood vessel walls. The result can be a heart attack in a patient who, on paper, seemed perfectly healthy.

High Lp(a) has been linked to heart attacks in patients in their 30s and 40s with no other known risk factors. If you’ve experienced an unexplained cardiac event, Lp(a) testing is essential.

Statins don’t lower it — and may make it worse

Statins are the most commonly prescribed cholesterol medications in the world, and they are highly effective at lowering LDL. But they have little to no effect on Lp(a) — and some studies suggest they may actually cause a modest increase.

PCSK9 inhibitors (like Repatha or Praluent) can modestly reduce Lp(a) — typically by 20–25% — but this is usually not enough to move a high level into a safe range. Niacin has shown some effect in studies but is not approved for Lp(a) treatment and carries significant side effects.

Some people are at much higher risk than others

Lp(a) affects people differently across populations. Research has shown that Black individuals are two to three times more likely to have elevated Lp(a) than white individuals — yet are also among the least likely to be tested.

You are at particularly high risk if you have:

• A family history of early heart disease (before age 55 in men, 65 in women)
• Familial hypercholesterolemia (inherited high cholesterol)
• A personal history of heart attack, stroke, or PAD — especially at a young age
• Recurrent cardiovascular events despite being on medications
• Calcific aortic valve disease

There is a treatment that works

Lipoprotein apheresis is an FDA-approved procedure that physically removes Lp(a), LDL, and ApoB particles directly from the bloodstream. Think of it as a filter for your blood — similar to how dialysis works for the kidneys.

Sessions are outpatient — no hospital stay required. Most patients read, work on a laptop, or watch TV during treatment. Our Boca Raton location is designed for comfort throughout.

You may qualify — and insurance may cover it

Lipoprotein apheresis is covered by Medicare and many private insurers for patients who meet specific clinical criteria. Coverage is based on your diagnosis, your cholesterol levels, and your cardiovascular history.

In general, you may qualify if you have familial hypercholesterolemia with high LDL or Lp(a), plus a history of coronary artery disease or peripheral artery disease. Our team reviews each patient’s full history and handles all insurance verification and prior authorization.

Florida Apheresis is one of the few dedicated outpatient apheresis centers in South Florida. We work directly with your cardiologist or primary care physician to coordinate your care every step of the way.