Question 1

How often should I have my Lp(a) levels tested?

Accepted Answer

Most people do not need regular Lp(a) testing as it is either high or not high and does not generally change very much. It is recommended that every American adult get their Lp(a) tested at least once in their life. Since Lp(a) levels are genetically determined and remain relatively stable throughout life, repeat testing is typically not necessary unless specific clinical circumstances warrant it.

Question 2

Can diet and exercise lower my Lp(a) levels?

Accepted Answer

Diet and exercise may not change Lp(a) levels because they are primarily determined by genetics. Genetic factors determine Lp(a) levels, and as a result, it can be difficult to alter them, and there are currently no specific treatments to do so. However, maintaining a healthy lifestyle is still crucial for overall cardiovascular health and managing other risk factors.

Question 3

What should I do if my Lp(a) level is high?

Accepted Answer

If Lp(a) levels are elevated, the focus should be on optimizing other cardiovascular risk factors. Anyone who has an elevated Lp(a) should work on lowering their LDL cholesterol as much as possible, with recommendations to lower LDL to less than 100 mg/dL for those without cardiovascular disease and less than 70 mg/dL for those with cardiovascular disease. This may involve lifestyle modifications and working with healthcare providers to manage blood pressure, diabetes, and other risk factors.

Question 4

Is the Lp(a) test covered by insurance?

Accepted Answer

Insurance coverage for Lp(a) testing varies by plan and clinical indication. The test uses CPT code 83695, which can help when requesting coverage. Many insurance plans are increasingly covering this test, especially when there is a clinical indication such as family history of heart disease or unexplained cardiovascular events. Individuals should check with their insurance provider about coverage.

Question 5

How does Lp(a) differ from regular cholesterol testing?

Accepted Answer

Lp(a) is not part of a standard lipid panel that checks the kinds of cholesterol everyone talks about. A lipoprotein(a) test is not included in a regular lipid panel and most people have never had their Lp(a) tested. While standard cholesterol tests measure total cholesterol, LDL, HDL, and triglycerides, the Lp(a) test specifically measures this unique cholesterol-carrying particle that provides additional cardiovascular risk information not captured by routine testing.

Question 6

Are there any treatments specifically for high Lp(a)?

Accepted Answer

Currently, there are no FDA-approved medications specifically designed to lower Lp(a) levels. In some cases, PCSK9 inhibitors have been shown to lower Lp(a) levels by about 20-30%. Lipoprotein apheresis, which removes excess Lp(a) and LDL cholesterol from the body, is another option, but for people with higher risks. Researchers are conducting large phase 3 trials testing if medications can lower Lp(a) levels, with results expected in about two to three years.