Major cardiology professional societies in the United States have updated their clinical practice guidelines to recommend routine testing for lipoprotein(a), or Lp(a), a significant genetic risk factor for atherosclerotic cardiovascular disease. The new guidance, a collaborative effort from the American Heart Association, American College of Cardiology, and other leading organizations, was published in the Journal of the American College of Cardiology and Circulation in late 2025.
Elevated Lp(a) levels are largely determined by genetics and are recognized as an independent, causal driver of heart attack and stroke risk. The updated guidelines now advise that all adults undergo at least one measurement of Lp(a) in their lifetime to identify those with high inherited risk. This marks a significant shift from prior recommendations, which suggested testing only in specific, limited scenarios.
The change follows years of accumulating evidence and advocacy from experts like Dr. Eric Topol, who highlighted the delay in incorporating this critical biomarker into standard care. The updated guidelines aim to facilitate earlier, more personalized prevention strategies, including more aggressive management of other risk factors like LDL cholesterol for patients with high Lp(a) levels.
