We have all filled out health history forms at the doctor’s office, the ones that ask about our family: mother, father, grandparents. I always listed the heart health issues on both sides of mine. My father died of a heart attack at 79. His father died of a heart attack too, and my maternal great-grandfather died of a burst aorta. I knew all of it, but I live a fairly healthy lifestyle, so I never gave it much thought.
That changed a few weeks ago, when I saw an Instagram post by Sarah Yoakam, MD (@sarahyoakammd) about the lipoprotein(a) blood test and what it reveals about genetically determined cardiac risk.
What Is Lipoprotein(a)?
According to MedlinePlus, lipoproteins are particles made of protein and fat that carry cholesterol through your bloodstream. The two main types are HDL (high-density lipoprotein), the “good” cholesterol, and LDL (low-density lipoprotein), the “bad” cholesterol.
Lipoprotein(a), often written Lp(a), is a type of LDL. High levels can build up in your arteries and form plaques, a condition called atherosclerosis. It thickens and stiffens the arteries and can lead to heart attack, stroke, heart disease, and blood clots. Lp(a) particles are also stickier than other LDL particles, which makes them more likely to cause blockages and clots.
Why the Test Matters
A routine cholesterol panel doesn’t measure Lp(a), so your standard numbers can look fine while your risk stays high. A lipoprotein(a) test gives a more accurate picture.
Lp(a) levels are also 80-90% genetic. You reach your adult level by about age 5, and it stays roughly the same for life. That means diet and exercise don’t move it much, no matter how well you take care of yourself.
My Experience
After seeing Dr. Yoakam’s post, I asked my primary care physician to add a lipoprotein(a) test to my next round of bloodwork. She added it without asking me to explain why, and my insurance covered it.
My result was 137 nmol/L. Levels of 125 nmol/L or higher are generally considered high, and I was shocked to see mine that far over. I was also a little scared. I had done everything I thought I was supposed to do, and the one number that mattered wasn’t something I could have changed with diet or exercise.
My doctor discussed statins with me, but first she ordered a coronary artery calcium (CAC) CT scan, which looks for hard plaque in the arteries of the heart. We’ll go over the results together and decide on next steps from there.
Why I’m Sharing This
I almost never found out. A routine cholesterol panel would have told me nothing about this risk, and I only knew to ask because of a social media post.
If you have a family history of heart attack, stroke, or aortic problems, or you simply want to understand your own risk better, I’d encourage you to talk with your doctor about adding a lipoprotein(a) test to your next bloodwork. It’s a simple blood draw, and for me it opened up a much more informed conversation about my heart health.
I’m sharing my personal experience, not medical advice. Please talk with your own doctor about what’s right for you.
