Lipoprotein (a) is a cholesterol-carrying particle in your blood that is linked to a higher risk of heart attack, stroke and narrowing of the aortic valve. It is written as Lp(a) and said aloud as "L-P-little-a".

Lp(a) is a type of low-density lipoprotein (LDL) with an extra protein, called apolipoprotein(a), attached to it.

Roughly one in five people worldwide has a raised Lp(a) level, yet most are never tested for it, since it is not part of a standard cholesterol panel.

Lp(a) is thought to raise heart risk in three ways, so it adds to the risk from your LDL rather than overlapping with it.

• Plaque build-up – Lp(a) becomes trapped in the artery wall and causes inflammation. This leads to plaque, which narrows the artery.
• Blood clotting – Your body uses a protein called plasminogen to dissolve clots. Apolipoprotein(a) has a similar structure and may block plasminogen from working, so clots take longer to break down.
• Aortic valve narrowing – Lp(a) collects in the aortic valve and causes calcium to build up. Over time the valve stiffens, a condition called calcific aortic stenosis, and restricts blood flow out of the heart.

The higher your Lp(a), the higher your risk, and that risk remains even when your LDL cholesterol is well controlled. Someone with a very high Lp(a) can have a normal cholesterol report and still have a much higher lifetime risk of early heart disease.

High Lp(a) is almost always inherited, and only a few medical conditions raise it further:

• Genetics – Your Lp(a) level is mainly determined by the genes you inherit. It is low at birth, reaches its adult level by around age 5 and changes little afterwards. If one parent has high Lp(a), each child has about a 1 in 2 chance of inheriting it.
• Kidney disease – Damaged kidneys clear less Lp(a) from your blood, so it builds up. Nephrotic syndrome (where protein leaks into the urine) and advanced kidney disease, including kidney failure treated with dialysis, can raise Lp(a) substantially. It often falls again once kidney function improves.
• An underactive thyroid (hypothyroidism) – Thyroid hormone helps your body break down and clear Lp(a), so when the hormone is low, Lp(a) rises. Treating the thyroid usually brings it back down.
• Menopause – Oestrogen suppresses the production of apolipoprotein(a), so Lp(a) tends to rise modestly as oestrogen falls.
• Inflammation – Lp(a) can rise or fall as part of your body's response to inflammation, so conditions such as rheumatoid arthritis can change it while the inflammation is active.

Conditions that lower Lp(a) may include:

• An overactive thyroid (hyperthyroidism) – Too much thyroid hormone speeds up how fast your body breaks down and removes Lp(a) from your blood, so your level falls.
• Liver disease – The liver is where Lp(a) is made, so a damaged liver makes less of it.

An unusually low Lp(a) level can occasionally be a sign of one of these conditions. Both usually cause other symptoms, such as weight loss and a fast heartbeat with an overactive thyroid, or tiredness and yellowing of the skin with liver disease, and need to be assessed by a doctor.

Lipoprotein (a) differs from LDL, ApoB and apolipoprotein A1 because it is inherited. Diet, exercise and medication can lower the other three, but they have little effect on your lipoprotein (a).

Lipoprotein (a) is often confused with apolipoprotein A1, but they are unrelated. Apolipoprotein A1 is the main protein on high-density lipoprotein (HDL), which carries cholesterol away from your artery walls, so a higher level is generally good. Lipoprotein (a) carries a different protein, apolipoprotein(a), and a higher level is linked to higher risk.

Lp(a) testing is most useful for people with a personal or family history of early heart disease, and international guidelines recommend that every adult has it measured at least once. You are more likely to benefit from testing if you have:

Repeat testing is rarely needed. One measurement in adulthood is usually enough, unless you develop a condition that changes your Lp(a) level, such as kidney disease or a thyroid problem.

The Lp(a) test uses a single blood sample taken from a vein in your arm, and it can be added to a cholesterol test or a heart screening package from the same sample. You do not need to fast beforehand.

The visit takes 30 to 60 minutes during off-peak periods. Results are ready in 3 to 5 days and are sent to you by email, and a doctor will explain what your result means for you.

A normal Lp(a) level is typically below 75 nmol/L (about 30 mg/dL), and a level above 125 nmol/L (about 50 mg/dL) is considered high. Your report may show either unit.

Lipoprotein (a) can be lowered partly with prescription treatments, such as PCSK9 inhibitors, niacin and lipoprotein apheresis.

Lp(a) cannot be lowered naturally, as diet, exercise and weight loss have little effect on it, and statins may even raise it slightly.

A high Lp(a) is strongly linked to heart attacks and strokes, and trials are still testing whether lowering Lp(a) itself prevents them. Knowing your level still helps, as international guidelines recommend tighter control of your other heart risks when Lp(a) is high: a lower LDL cholesterol target, often with a statin, well-controlled blood pressure and blood sugar, no smoking and regular exercise.

A coronary calcium score can also show whether plaque has already formed in your heart's arteries. Your parents, siblings and children may want to be tested too.

At ATA Medical, we offer the lipoprotein (a) test on its own or alongside other cardiovascular markers, with consultation and results review. Prices are as follows:

Test / Treatment	Price*
Consultation	From $49.05
Lipoprotein (a)	$49.99
Apolipoprotein B (ApoB)	$32.70
High-sensitivity CRP (hsCRP, an inflammation marker)	$38.15
CT Calcium Score	$403.30
Essential Lipid Profile Full Cholesterol Test (Total, LDL, HDL, Triglycerides, HDL Ratio)	$21.80
Cardiac Screening 3 Essential Lipid Profile + Apolipoprotein B (ApoB) + HsCRP	$63.22
Cardiac Screening 4 Cardiac Screening 3 + Homocysteine + Fasting Insulin + Glucose. Note: Fasting is required for accurate results of Fasting Insulin and Glucose.	$172.22
PCSK9 Inhibitor Injections (for High LDL Cholesterol)
Evolocumab (140 mg): Once or twice a month	$123.00 per injection
Inclisiran: Typically every 6 months	$3,828.00 per injection

*Prices are NETT and inclusive of GST.
^Prices last updated on Sep 24, 2026. While every effort is made to keep pricing information up to date, please contact our team to confirm the latest rates.

The Lp(a) test is not covered by Healthier SG Screening, so it is not subsidised under the programme.

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