Lp(a) Clinical Guidance
Lp(a) is a cholesterol-carrying macromolecule circulating in the blood that can damage your arteries, causing a heart attack or stroke. The Lp(a) level in your blood is largely inherited. Indeed, high Lp(a) levels may be the most commonly inherited cause of heart attacks and strokes.
This website will help you determine how much your Lp(a) level increases your risk of having a heart attack or stroke, and provide you with specific guidance about what you can do to lower your risk if your Lp(a) level is elevated.
Estimating the risk of heart attack & stroke caused by Lp(a)
Please enter your health information in the boxes below. After you enter your information, a graph will appear to show you your estimated risk of having a heart attack, stroke, or undergoing a procedure to clear a blocked artery at any age up to age 80.
This estimated risk does not take into account your Lp(a) level. The only way to know how much your Lp(a) level increases your risk of having a heart attack or stroke is to measure it. Persons with high levels of Lp(a) may be at increased risk and not even know it.
To see how much your Lp(a) level increases your risk of having a heart attack or stroke, enter your Lp(a) level using the slider bar below the graph. A second line will appear on the graph showing you how much your Lp(a) level increases your risk of having a heart attack or stroke.
Enter your health information below
Cholesterol units:
Height units:
Weight units:
Cholesterol
Your BMI is calculated as:
Please make sure to fill all of the fields
This estimated risk does not take into account the Lp(a) levels in your blood. To see how much your Lp(a) level increases your risk of having a heart attack or stroke, enter your Lp(a) level into the box below. A new line will appear on the graph showing you how much your Lp(a) level increases your risk of having a heart attack or stroke at all ages up to age 80.
Lp(a) units:
First, it is important to be aware that the level of Lp(a) in your blood is mostly inherited. If you have high blood levels of Lp(a), then other members of your family may also be at increased risk of heart attack or stroke because of high Lp(a) levels. So, if your Lp(a) level is elevated, or if your risk of heart attack and stroke is increased by your Lp(a) levels, then other members of your family may also benefit from measuring their Lp(a) levels to determine if they are at increased risk.
Unfortunately, Lp(a) levels in the blood cannot be lowered by diet or exercise. In addition, there are no approved medicines that specifically lower Lp(a) levels. Fortunately, new very powerful Lp(a) lowering therapies are currently in development.
However, until those medications become available, you can still reduce your risk of having a heart attack or stroke despite having high Lp(a) levels. Current clinical practice guidelines recommend that if you are at increased risk of heart attack and stroke caused by elevated Lp(a) levels, then you should more intensely lower other causes of heart attack and stroke, such as your LDL or blood pressure level.
Although lowering LDL and blood pressure will not lower your Lp(a) level, it will reduce your overall risk of having a heart attack and stroke.
Using the slider bars below, you can estimate how much you would have to lower your LDL or blood pressure to reduce your risk of heart attack and stroke by about the same amount as the increased risk caused by your Lp(a) level. This information can help guide you about how much more intensely you need to lower your LDL and blood pressure beyond current recommendations to improve your cardiovascular health despite having high Lp(a) levels.
You can use the slider bars below to estimate how much you can reduce your risk of having a heart attack or stroke by lowering your LDL and blood pressure levels. After using the slider bars, a new line will appear on the graph showing you your risk of having a heart attack or stroke that includes both your Lp(a) level and the effect of lowering your LDL or blood pressure.
When the light blue line and the dark blue line overlap, this is the amount you have to reduce your LDL or blood pressure in order to compensate for the increased risk caused by your Lp(a) levels.
Reducing your risk of heart attack and stroke
Because lowering LDL and systolic blood pressure does not reduce your Lp(a) levels, Lp(a) is still circulating in your blood and can damage your arteries. For that reason, the best way to reduce your risk of having a heart attack or stroke caused by Lp(a) is with a medicine that directly lowers Lp(a).
Potent Lp(a) lowering therapies are currently being developed. Hopefully, these new therapies will become available soon and can be used to directly reduce the risk of heart attack and stroke among persons with high Lp(a) levels.
Further information
For the latest practical and scientific information about Lp(a), please read the new updated 2022 European Atherosclerosis Society (EAS) International Expert Consensus Statement on Lp(a), which can be found here: https://doi.org/10.1093/eurheartj/ehac361
Additional information about how to reduce your risk of having a heart attack or stroke is provided in the 2019 ESC/EAS Clinical Practice Guidelines and in the EAS Expert Consensus Statement on LDL listed below.
- Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement,European Heart Journal, 2022.
- 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020 Jan 1;41(1):111-188. doi: 10.1093/eurheartj/ehz455.
- Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2017 21;38(32):2459-2472. doi: 10.1093/eurheartj/ehx144.
About Causal AI
Causal AI is the next generation of artifical intelligence (AI) that embeds causal reasoning and causal effects into an ensemble of AI algorithms. Adding causal effects enables AI to go beyond simple prediction to prescribe specific actions that can change outcomes.
This AI application embeds the causal effects of Lp(a), LDL, and SBP on the risk of having a heart attack or stroke. Including causal effects in discrete time-units of exposure to reflect the biology of how atherosclerosis develops permits an accurate prediction of the risk caused by your Lp(a), LDL, and SBP levels - in the context of all your other risk factors - and an accurate estimate of the benefit you can achieve by lowering your Lp(a), LDL, and SBP beginning at any age and extending for any duration. This information can then be used to prescribe specific actions to personalize the prevention of cardiovascular disease and introduce the era of precision cardiovascular health.
Further information can be found at:
Causal AI substantially improves the validity of estimating cardiovascular risk and benefit. Ference TB, Sniderman AD, Deanfield JD, Catapano AL, and Ference BA, Presented as a HOTLINE Late Breaking Clinical Trial at the 2022 European Society of Cardiology Annual Scientific Congress in Barcelona on 28 August 2022
Available at the ESC 2022 website: www.escardio.org/Congresses-&-Events/ESC-Congress