Lipoprotein(a) Test in 2026. What Your Result Means, Who Should Be Tested and What the Latest Trial Changes
Lipoprotein(a), written Lp(a), is a cholesterol-carrying particle in the blood that raises the risk of heart attack, stroke and narrowing of the aortic valve, and around 1 in 5 people have a raised level. Its level is mostly set by your genes, changes little through life and is not lowered by diet or exercise, which is why European guidance recommends that every adult has it measured at least once. A standard NHS cholesterol test does not include it. UK laboratories grade results in nmol/L, with 32 to 90 a minor increase in risk, 90 to 200 moderate, 200 to 400 high and above 400 very high. On 4 September 2026, the Lp(a)HORIZON trial of 8,323 people with heart disease reported that pelacarsen, a drug that lowers Lp(a), did not reduce heart attacks, strokes or cardiovascular deaths. That result does not make the test less useful. A raised level is still a proven risk factor, and knowing it changes how firmly blood pressure, LDL cholesterol and apolipoprotein B should be managed, and whether parents, brothers, sisters and children should be tested too. At The Wellness, Lp(a) is measured as part of the Complete Biomarker Assessment from £1,400, alongside ApoB and over 100 other markers, and every result is explained by a doctor. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated 2 October 2026, to include the Lp(a)HORIZON trial results announced in September 2026.
Book an Lp(a) test on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
Key facts about lipoprotein(a)
Around 1 in 5 people have a raised level, and most do not know.
The level is mostly inherited and stays broadly stable through adult life, so one measurement is usually enough.
It is not included in a standard cholesterol test and must be requested separately.
Diet, exercise and statins do not lower it meaningfully.
A raised level adds to the risk from LDL cholesterol, blood pressure, smoking and diabetes, so those are treated more firmly.
First-degree relatives of someone with a high level should be offered testing.
What is lipoprotein(a)
Lp(a) is an LDL-like particle with an extra protein, apolipoprotein(a), attached to it. That extra protein makes the particle more likely to settle in artery walls, promote inflammation and encourage clotting.
High levels are linked to coronary heart disease, heart attack, stroke, peripheral arterial disease and calcific aortic valve stenosis, a narrowing of the main valve leaving the heart.
Because the level is genetic, it can be high in people who are slim, active and otherwise healthy, and it is a common explanation for a heart attack in someone with no obvious risk factors.
Who should have an Lp(a) test
The 2022 European Atherosclerosis Society consensus statement recommends measuring Lp(a) at least once in every adult. HEART UK recommends testing in particular in the following groups.
a personal or family history of heart disease or stroke before the age of 60
a parent, brother, sister or child with a raised Lp(a)
familial hypercholesterolaemia or another inherited cholesterol disorder
aortic valve stenosis
a borderline 10-year cardiovascular risk, where the result could change the decision about treatment
A repeat test is not usually needed, unless something that temporarily changes the level is present, such as kidney disease, an underactive thyroid or pregnancy.
Ask whether you should be tested on WhatsApp or email team@thewellnesslondon.com.
What does an Lp(a) result mean
UK laboratories report Lp(a) in nmol/L, which counts particles. Some laboratories and older reports use mg/dL, which measures mass, and the two cannot be converted precisely, so it matters which unit your result uses.
Following the UK consensus thresholds, a result below 32 nmol/L is not associated with extra risk. From 32 to 90 the extra risk is minor, from 90 to 200 moderate, from 200 to 400 high, and above 400 very high. The European consensus notes that levels above about 430 nmol/L carry a lifetime risk similar to inherited high cholesterol.
The result is never read alone. It is added to your age, blood pressure, cholesterol, ApoB, smoking status, blood sugar and family history to give an overall picture of risk.
What did the Lp(a)HORIZON trial show
Lp(a)HORIZON tested pelacarsen, an injected drug that lowers Lp(a) substantially, in 8,323 people who already had heart disease and a level of at least 70 mg/dL. In September 2026, Novartis announced that the drug lowered Lp(a) as expected but did not reduce the combined rate of cardiovascular death, heart attack, stroke and urgent heart procedures compared with placebo. The full results are due to be presented at a medical meeting.
The result is disappointing, and it raises questions about whether lowering Lp(a) with a drug will protect the heart. Other Lp(a)-lowering drugs, including olpasiran and lepodisiran, are still in large outcome trials.
What the trial does not change is that a raised Lp(a) is a well-established, inherited risk factor. Measuring it still identifies people who benefit from stricter control of every other risk they can change, and families who should be tested.
What should you do if your Lp(a) is high
Lower everything else that can be lowered. HEART UK advises more intensive management of LDL cholesterol and other risk factors in people with a raised Lp(a). That usually means a lower target for LDL cholesterol and ApoB, careful blood pressure control, and stopping smoking.
Refine the risk where the decision is uncertain. A coronary artery calcium score, a CT scan that measures calcified plaque in the heart arteries, can show whether disease is already present.
Check the family. First-degree relatives have around a 1 in 2 chance of carrying the same high level, and a single blood test answers the question.
Keep the result. Because it rarely changes, the number belongs in your permanent medical record and should be shared with any doctor assessing your heart.
What does an Lp(a) test cost in London
At the top of the London market, MRI-led health programmes run beyond £15,000, and advanced biomarker panels including Lp(a) commonly cost around £1,000.
At The Wellness every blood test is chosen after an assessment and explained by a doctor. All figures are from prices.
Platinum Membership, from £17,450 a year. Signature Membership, from £6,950 a year or £610 a month.
Executive Health Programme, the most comprehensive single assessment, from £11,995.
Heart health body scan programme, from £3,495.
Complete Biomarker Assessment, over 100 markers including Lp(a) and ApoB, with consultation, from £1,400.
Comprehensive Blood Panel with consultation and interpretation, from £495, with Lp(a) added on request.
In-person consultation, 30 minutes with examination, from £220.
Appointments are usually available the same week at our London clinics, including Marylebone and Belgravia.
Why patients choose The Wellness for heart risk testing
Because Lp(a) is measured with the markers that give it meaning, including ApoB, a full lipid profile, HbA1c and kidney function.
Because the result is explained. You leave knowing what your level means, what it changes and what it does not.
Because the advice is current. Our guidance reflects the September 2026 trial results rather than claims made before them.
And because a finding leads somewhere, with a plan for cholesterol and blood pressure, a calcium score where it would help, testing for your family and referral to a consultant cardiologist where needed.
Related reading
Full health check in London covers what a complete assessment should include, full health check in your 30s covers the tests that matter early, heart palpitations and ECG covers when a heart symptom is urgent, and private GP membership covers ongoing care with one doctor.
Book your Lp(a) test today on WhatsApp or call 020 3951 3429.
Frequently asked questions
What is a normal Lp(a) level
UK laboratories treat a result below 32 nmol/L as carrying no extra risk. From 32 to 90 nmol/L the extra risk is minor, from 90 to 200 moderate, from 200 to 400 high, and above 400 very high.
How often should Lp(a) be tested
Usually once in a lifetime, because the level is mostly set by your genes and changes little. A repeat test is considered if kidney disease, an underactive thyroid or pregnancy may have affected the first result.
Can you lower Lp(a) naturally
Not meaningfully. Diet and exercise have little effect on Lp(a), and statins do not lower it. They still matter, because lowering LDL cholesterol, blood pressure and other risks reduces the overall danger of a high Lp(a).
Did the pelacarsen trial fail
In September 2026, Lp(a)HORIZON reported that pelacarsen lowered Lp(a) but did not reduce heart attacks, strokes or cardiovascular deaths in 8,323 people with heart disease. Other Lp(a)-lowering drugs are still being tested.
Is Lp(a) included in a normal cholesterol test
No. A standard cholesterol test measures total, LDL and HDL cholesterol and triglycerides. Lp(a) has to be requested separately.
Where can I get an Lp(a) test in London
At The Wellness, Lp(a) is included in the Complete Biomarker Assessment from £1,400 and can be added to the Comprehensive Blood Panel from £495, with every result explained by a doctor.
The Wellness is a doctor-led private healthcare group providing medical care from our London clinics, including Marylebone and Belgravia. All doctors are GMC-registered. Imaging is arranged at specialist centres and reported by consultant radiologists, and blood analysis is performed by accredited laboratories. In an emergency call 999. This article is general information and not a substitute for medical advice about your own health.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
