Lipoprotein(a): the neglected risk factor in cardiovascular health

Lipoprotein(a) [Lp(a)] is a well recognised contributor in the development of cardiovascular disease. Unlike other lipoproteins, Lp(a) levels are primarily genetically determined, and in most individuals remain largely stable throughout life. Elevated Lp(a) is common in the general population, and various international guidelines now recommend at least one lifetime measurement of Lp(a) and its inclusion into an individual's cardiovascular risk assessment. Despite this, Lp(a) is still rarely measured, even in patients with known cardiovascular risk factors. Critically, the therapeutic landscape for Lp(a)-lowering medications is rapidly evolving with multiple drugs showing considerable promise in late-stage clinical trials. The strength and consistency of the evidence now cement Lp(a) as an essential biomarker of cardiovascular health. Failure to incorporate measurement of Lp(a) into clinical practice will continue to underestimate an individual's risk of CVD. Now is the time for Lp(a) to move from a neglected biomarker to a widely known and measured essential component of cardiovascular risk assessment.