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Lp(a) – The Overlooked Risk Factor in Cardiovascular Health

January 14, 2026
Reagents

Cardiovascular disease (CVD) remains the leading global cause of death, with over 19.4 million deaths reported in 2021, despite advances in prevention and treatment. Lp(a) is a genetically determined lipoprotein that significantly increases CVD risk but is rarely measured in clinical practice.

Recently, Randox Health released their latest publication that highlight global modelling studies which suggest more than 1.8 billion people have high Lp(a) levels worldwide. During the study, Randox looked at anonymous results from people who visited Randox Health Clinics in the UK for routine health checks. Out of 26,619 people tested for Lp(a):

 

  • About 1 in 6 people (17.6%) had high Lp(a) levels according to EAS guidelines, putting them at increased risk of heart disease.
  • Another 5% were in the “grey area”.
  • The remaining 74% had levels considered low risk

 

Click to read the full study

Why Lipoprotein(a) Matters

 

  • Independent Risk Factor: Elevated Lp(a) is causally linked to atherosclerotic cardiovascular disease and aortic valve stenosis.
  • Prevalence: Over 1.8 billion people worldwide have elevated Lp(a) levels.
  • Genetic Determination: Unlike LDL cholesterol, Lp(a) levels are largely unaffected by lifestyle changes or conventional lipid-lowering therapies.

 

Current Challenges

 

  • Low Testing Rates: Studies show <1% of patients undergo Lp(a) testing, even those with CVD history.
  • Measurement Variability: Isoform size differences and inconsistent reporting units (mass vs. molar) have historically undermined confidence.
  • Lack of Consensus on Risk Thresholds: Guidelines differ on cut-off levels for high risk, complicating clinical interpretation

 

Clinical Implications

 

  • Underestimated Risk: Current calculators like QRISK3 omit Lp(a), leading to misclassification of high-risk individuals
  • Ethnic Variability: Certain populations (e.g., Black and South Asian) have higher median Lp(a) levels, amplifying health disparities.

 

Emerging Solutions

 

  • Standardisation: HEART UK and international bodies advocate for uniform measurement protocols and reporting in nmol/L.
  • Therapeutic Advances: Novel agents in late-stage trials (Pelacarsen, Olpasiran, Lepodisiran) show up to 80–100% reductions in Lp(a).
  • Policy Initiatives: The Brussels Declaration calls for global integration of Lp(a) testing into health strategies.

 

Testing Solutions

 

Randox Lp(a) Assay Highlights:

 

  • Ready-to-Use: Liquid format for convenience.
  • Accurate Calibration: Five-point calibrator (nmol/L) reflects apo(a) isoform variability.
  • Complete Package: Dedicated Lp(a) control included.
  • Traceable & Standardized: Calibrated in nmol/L, aligned to WHO/IFCC reference material for minimal bias.
  • Superior Accuracy: Measures particle concentration, avoiding size-related bias of mass-based methods.
  • High Performance: Correlation r=0.995 vs. other methods; within-run precision <2.54%.
  • Applications available for a wide range of instrument-specific settings.