If someone in your family has high lipoprotein(a), or Lp(a), their biological parents, siblings and children should ask their healthcare professionals about testing. Lp(a) is a largely inherited cardiovascular risk factor that can increase the likelihood of heart attack, stroke and certain forms of aortic valve disease.
A normal cholesterol test does not rule out elevated Lp(a). The test must be specifically ordered because it is not part of a standard lipid panel.
At Lab On Demand in Indianapolis, we support cardiovascular risk assessment through preventive, wellness and longevity-focused laboratory testing. Understanding inherited risk factors can help individuals and families make informed decisions about long-term health.
What is Lp(a), and why does it matter for heart health?
Lipoprotein(a), pronounced lipoprotein little a, is a cholesterol-carrying particle in the bloodstream.
It resembles LDL cholesterol but contains an additional protein called apolipoprotein(a).
Elevated Lp(a) is associated with increased risk of:
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Coronary artery disease
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Heart attack
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Ischemic stroke
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Calcific aortic valve stenosis
Unlike many other cardiovascular risk factors, Lp(a) levels are primarily determined by genetics and generally remain relatively stable throughout adulthood.
Having high Lp(a) does not mean heart disease is inevitable. It means the result should be considered alongside LDL cholesterol, blood pressure, diabetes, smoking history and other risk factors.
The 2026 ACC/AHA dyslipidemia guideline recommends measuring Lp(a) at least once during adulthood.
Who should get tested if high Lp(a) runs in the family?
When someone has elevated Lp(a), testing their first-degree biological relatives can identify other family members with increased cardiovascular risk.
This approach is called cascade screening.
1. Biological parents
If your parent has high Lp(a), you may have inherited a tendency toward elevated levels.
Your parent’s result cannot establish your own Lp(a) concentration, so an individual blood test is needed.
2. Biological brothers and sisters
Siblings may share inherited cardiovascular risk factors, but their Lp(a) levels can differ substantially.
A sibling’s normal cholesterol panel does not establish that their Lp(a) is normal.
3. Biological children
Children of someone with high Lp(a) may also have elevated levels.
Testing in children should be discussed with a pediatric healthcare professional, particularly when there is a family history of premature cardiovascular disease or inherited lipid disorders.
Pediatric testing decisions differ from routine adult screening.
What about grandparents, aunts, uncles and cousins?
These relatives may also share inherited risk factors.
Discuss the broader family history with a healthcare professional, especially if multiple relatives experienced heart attacks, strokes or cardiovascular disease at relatively young ages.
Should every adult have an Lp(a) test?
The 2026 ACC/AHA guideline recommends that all adults have Lp(a) measured at least once in their lifetime.
This recommendation reflects the value of identifying an inherited risk factor that may otherwise remain undetected.
Testing is particularly relevant when someone has:
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A first-degree relative with elevated Lp(a)
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A family history of premature heart attack or stroke
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Familial hypercholesterolemia
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Cardiovascular disease that seems disproportionate to traditional risk factors
Because Lp(a) is usually stable, frequent repeat testing is not routinely necessary.
Your clinician may recommend additional testing in certain circumstances.
Is Lp(a) included in a regular cholesterol test?
No. A standard lipid panel typically measures total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides. Lp(a) requires a separate measurement.
Someone can have an acceptable LDL cholesterol level while still having elevated Lp(a).
For a broader explanation of cardiovascular biomarkers, read our advanced lipid testing guide.
What is considered a high Lp(a) level?
Lp(a) results may be reported in milligrams per deciliter (mg/dL) or nanomoles per liter (nmol/L).
According to the 2026 ACC/AHA guideline, levels of 125 nmol/L or higher, or 50 mg/dL or higher, are considered a cardiovascular risk-enhancing factor.
Higher levels are generally associated with greater cardiovascular risk.
The two measurement units are not directly interchangeable using a single universal conversion factor. Your healthcare professional should interpret the value using the reported units and laboratory method.
An elevated result is not a diagnosis of heart disease. It provides additional information for cardiovascular risk assessment.
What should you do if your Lp(a) is high?
Although genetics largely determine Lp(a), other cardiovascular risk factors remain important and modifiable.
Your healthcare professional may recommend:
- Reviewing LDL cholesterol and other lipid measurements.
- Managing blood pressure and blood glucose.
- Avoiding tobacco exposure.
- Maintaining regular physical activity and a heart-healthy diet.
- Discussing whether cholesterol-lowering medication is appropriate.
- Reviewing family history and considering testing for biological relatives.
Lifestyle changes may not substantially reduce Lp(a) itself, but they can help reduce overall cardiovascular risk.
Can oral bacteria and gum disease affect cardiovascular health?
Oral health is another important consideration in whole-body cardiovascular wellness.
Research has identified an association between periodontal disease (gum disease) and cardiovascular disease.
When gums are inflamed, bacteria from the mouth can enter the bloodstream. Researchers are studying how these bacteria and the resulting inflammatory response may contribute to blood-vessel inflammation and endothelial dysfunction.
The American Heart Association’s 2025 scientific statement, published in Circulation in 2026, describes these potential biological mechanisms.
However, an association does not prove that gum disease directly causes heart disease, and it has not been established that periodontal treatment prevents heart attacks or strokes.
Maintaining good oral hygiene, receiving appropriate dental care and addressing periodontal disease are valuable parts of overall health.
Oral bacteria do not explain inherited high Lp(a). These are separate considerations that may both be relevant to a comprehensive cardiovascular-health discussion.
Source: American Heart Association — Periodontal Disease and Atherosclerotic Cardiovascular Disease.
How does Lp(a) testing fit into longevity and preventive laboratory testing?
At Lab On Demand, we recognize that understanding cardiovascular risk is an important part of long-term preventive health.
Our Indianapolis laboratory offers testing options relevant to metabolic health, cardiovascular risk assessment, hormonal health and general wellness.
Depending on clinical needs and test availability, a preventive laboratory evaluation may include:
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Lipoprotein(a), when available and specifically ordered
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Standard cholesterol and lipid testing
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Advanced lipid markers
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Hemoglobin A1c
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Blood glucose and metabolic panels
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Other individualized laboratory tests
No single laboratory result can predict how long someone will live or guarantee prevention of cardiovascular disease.
The value of longevity-focused testing comes from selecting meaningful biomarkers and reviewing the findings with a qualified healthcare professional.
Lab On Demand also provides immigration medical examination services in Indianapolis. Those examinations follow separate USCIS and CDC requirements; Lp(a) is not a routine requirement of Form I-693.
Frequently asked questions about inherited Lp(a)
If my father or mother has high Lp(a), will I have it too?
Not necessarily. You may share inherited risk, but your own Lp(a) level must be measured.
Can Lp(a) be high even when LDL cholesterol is normal?
Yes. Lp(a) and LDL cholesterol are separate measurements.
Is Lp(a) testing a genetic test?
No. It is a blood test that measures Lp(a) concentration, although the level is largely genetically determined.
Do I need to fast before an Lp(a) test?
Fasting is generally not required for Lp(a) testing alone. If other laboratory tests are being collected at the same visit, preparation requirements may differ.
Can exercise and diet lower Lp(a)?
Diet and exercise usually have limited effects on genetically determined Lp(a) concentrations, but they remain important for overall cardiovascular health.
Does high Lp(a) mean I will have a heart attack?
No. Elevated Lp(a) increases risk but does not predict an individual cardiovascular event with certainty.
Can gum disease increase cardiovascular risk?
Periodontal disease is associated with increased cardiovascular risk. Oral bacteria and inflammation are possible contributing mechanisms, but a direct causal relationship has not been established.
Cardiovascular and longevity blood testing in Indianapolis
Lab On Demand serves patients from Indianapolis and surrounding Central Indiana communities who are interested in cardiovascular laboratory testing, preventive wellness and longevity-focused blood work.
Our Indianapolis location welcomes appointment inquiries from individuals in:
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Indianapolis
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Carmel
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Fishers
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Noblesville
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Westfield
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Zionsville
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Lawrence
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Greenwood
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Southport
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Beech Grove
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Plainfield
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Avon
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Brownsburg
These are communities from which patients may travel to our Indianapolis location, not separate Lab On Demand offices.
If elevated Lp(a) has been identified in your family, ask your healthcare professional whether testing is appropriate for you.
Request a cardiovascular lab appointment
Interested in learning more about Lp(a) testing or other cardiovascular biomarkers?
Contact Lab On Demand to confirm Lp(a) availability, ordering requirements, preparation and current pricing.
Lab On Demand | Indianapolis, Indiana
We provide laboratory testing services for preventive health, longevity-focused wellness and immigration medical examinations.
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