High cholesterol has long been known as a major factor that raises the risk of cardiovascular disease (CVD). But new research shows that one specific type of cholesterol-related particle is Lipoprotein(a), or Lp(a) may play a much bigger role, especially in healthy women with no existing heart problems.
A new long-term study suggests that elevated Lp(a) levels can predict heart disease risk up to 30 years in advance, even when a woman appears perfectly healthy. This has led experts to recommend routine screening for Lp(a) so prevention can begin early.
This article explains what Lp(a) is, why it matters, and how women can reduce their cardiovascular risk even if their genetics place them at a disadvantage.
What Is Lipoprotein(a) and Why It Matters
Most people are familiar with:
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LDL-C – “bad cholesterol”
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HDL-C – “good cholesterol”
But Lp(a) is different:
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It is a cholesterol-carrying particle made mostly due to genetics.
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Diet and lifestyle have little effect on its levels.
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High levels can damage blood vessels, leading to heart attacks, strokes, and artery blockages.
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Around 20–25% of the global population has elevated Lp(a).
Doctors now consider it an independent and strong predictor of future cardiovascular disease.
New Study: High Lp(a) Raises 30-Year CVD Risk in Healthy Women
A recent long-term study analyzed data from more than 27,000 healthy women over nearly 30 years. Researchers measured their Lp(a) levels at the beginning and followed their heart health over time.
Key Findings
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Women with Lp(a) above 30 mg/dL had a higher risk of major cardiovascular events.
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Extremely high levels (120 mg/dL and above) showed:
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Higher risk of heart attack
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Higher risk of coronary heart disease
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Higher risk of ischemic stroke
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Higher risk of death from cardiovascular causes
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Women with a gene associated with high Lp(a) had increased chances of CVD, even when otherwise healthy.
Why This Matters
This study proves that Lp(a) can silently raise heart risk decades before symptoms appear, making early detection crucial.
Lp(a) Levels and Associated Risk
Here’s how women were grouped based on Lp(a):
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Below 10 mg/dL
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10–30 mg/dL
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30–60 mg/dL
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60–90 mg/dL
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90–120 mg/dL
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120+ mg/dL
Risk of heart disease started rising above 30 mg/dL, and became significantly high above 120 mg/dL.
Can You Lower Lp(a)?
Currently, no approved medications directly target Lp(a). Some therapies are in advanced trials, but none are widely available yet.
However, you can lower overall cardiovascular risk, which is just as important.
How Women Can Reduce Heart Disease Risk Even With High Lp(a)
Even if genetics raise your Lp(a), you can reduce your overall risk significantly.
1. Lower LDL Cholesterol
Since Lp(a) contributes to total LDL levels, lowering LDL is crucial.
Treatment options:
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Statins
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Ezetimibe
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PCSK9 inhibitors (can lower Lp(a) slightly but not approved for this purpose)
2. Adopt a Heart-Healthy Lifestyle
This includes:
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High-fiber diet rich in fruits, vegetables, whole grains
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Limited saturated fats and processed foods
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Regular physical activity (150 minutes/week)
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Maintaining healthy weight
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No smoking or vaping
3. Manage Other Risk Factors
Keep these under control:
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Blood pressure
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Blood sugar
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Weight
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Chronic inflammation
Even with high Lp(a), these steps dramatically reduce the chances of heart attack or stroke.
Should Lp(a) Screening Be Routine?
Many experts say yes.
Why Screening Matters
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Lp(a) is genetic which you only need the test once in your lifetime.
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Helps identify risk early.
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Can guide preventive treatment.
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Especially important if you have a family history of heart disease.
Since elevated Lp(a) may affect one-quarter of adults globally, early screening can help millions take preventive action.
Conclusion
High cholesterol and Lp(a) are major predictors of heart disease even in healthy women with no symptoms. Since Lp(a) levels are genetic and difficult to change, early detection becomes invaluable.
The good news: Heart disease risk is not fixed. With proactive screening, healthy lifestyle choices, and appropriate medical care, women with high Lp(a) can significantly reduce their long-term cardiovascular risk.
