My Lp(a) is high — what should I do?
Lp(a) is largely genetic and measured once in a lifetime. Elevation amplifies atherosclerotic and aortic-valve risk and motivates aggressive ApoB lowering. PCSK9 inhibitors lower Lp(a) modestly; novel siRNAs are in late-stage trials.
Full answer
Lp(a) is genetically determined for most adults and is measured once in a lifetime. Elevation does not change day to day. The clinical implication is to lower ApoB more aggressively, control blood pressure, avoid smoking, and screen for premature atherosclerotic and aortic-valve disease. Lifestyle does not meaningfully change Lp(a). Statins do not lower it. PCSK9 inhibitors lower it modestly. Novel siRNA therapies (pelacarsen, olpasiran, lepodisiran) are in late-stage trials. Family screening is appropriate when Lp(a) is markedly elevated.
Educational. Not a substitute for individualized provider review.
- Methodology — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03