At my annual physical, I brought a list of concerns, feeling uneasy after learning that three of my siblings have high Lp(a), a form of cholesterol that increases the risk of heart and vascular disease. “I think I should get tested too,” I told my doctor. He nodded calmly and said, “Absolutely—and we should talk about what that means for you. Starting with a statin.”
Days later, my results came back: elevated Lp(a), or lipoprotein(a). I’ve never obsessed over cholesterol, blood pressure or diet—my numbers always looked fine—because I thought I was doing enough by eating salmon, walnuts and olive oil regularly. But Lp(a) is different: it’s genetic, unaffected by diet or lifestyle, and fixed at birth. With a 50 percent chance of passing to children or siblings, it quietly runs in families.
What could I do? I couldn’t lower Lp(a) with kale or cardio. But I could take control of other risk factors—keep my LDL low, manage blood pressure and blood sugar and stay active. My doctor mentioned statins, which don’t directly affect Lp(a) but effectively reduce LDL and overall risk. Niacin and estrogen therapy were also referenced, but their side effects and limited benefits make them less viable for me. The hopeful part? Scientists are developing next-gen RNA therapies that could reduce Lp(a) by 80–100 percent in early studies. But they’re not approved yet, and we don’t know if lowering Lp(a) this way will reduce heart attacks or strokes. So for now, lifestyle remains my best tool.
I left that appointment cautiously optimistic, committed to a new strategy: living healthier, taking my statin, checking in with my siblings and watching trial results closely.
If your family has high Lp(a), ask your provider to test you—it’s a one-time, non-fasting blood draw. Don’t panic if your Lp(a) is elevated. Use that as fuel to strengthen your heart-health game while research evolves. Lp(a) may be in your genetic makeup, but that doesn’t mean it determines your fate.
Pepper Evans works as an independent-living consultant, helping older adults age in place. She is the empty-nest mother of two adult daughters and has extensive personal and professional experience as a caregiver. She has worked as a researcher and editor for authors and filmmakers. She also puts her time and resources to use in the nonprofit sector and serves on the Board of Education in Lawrence Township, NJ.
