Updated clinical guidelines for cholesterol management now call for a one-time test for lipoprotein(a), or Lp(a), in all adults. The recommendation, issued by the National Lipid Association (NLA) in late 2025, aims to identify individuals with a genetically elevated risk for atherosclerotic cardiovascular disease (ASCVD).
Lp(a) is a type of lipoprotein particle in the blood, and high levels are a significant, independent risk factor for heart attack and stroke. Unlike LDL ("bad") cholesterol, Lp(a) levels are largely determined by genetics and are not significantly influenced by diet or most standard cholesterol medications like statins.
The new guidelines emphasize more aggressive prevention strategies, including earlier and more comprehensive risk assessment. Identifying high Lp(a) allows healthcare providers to intensify management of other modifiable risk factors, such as blood pressure and LDL cholesterol, in affected patients.
While specific Lp(a)-lowering therapies are still in development, the NLA states that the test's value lies in risk stratification and motivating patients toward optimal cardiovascular health. The one-time test is considered sufficient as Lp(a) levels remain relatively stable throughout life.
