Understanding Lipoprotein Tests

Have a family history of heart disease? To determine if you are at risk for developing cardiovascular disease, your doctor may suggest that you be given a cardiac risk assessment. Cardiac risk assessments include a series of tests, as well as a review of your personal medical history, to help assess the likelihood that you may have a future cardiovascular event such as a heart attack or stroke.

Among the tests used to assess your cardiac risk is a lipoprotein (a), or Lp(a), blood test. Lipoproteins are molecules made of proteins and fat-like substances and they carry cholesterol and triglycerides throughout the blood. Lp (a) is a type of LDL ("bad") cholesterol. If you have too much LDL cholesterol in your blood, fatty deposits, or plaques, can form in your arteries, reducing blood flow. In some instances, these plaque deposits rupture causing heart and vascular problems.

Unlike cholesterol that can be modified through lifestyle changes such as diet and exercise, Lp(a) cholesterol is determined by your genes and isn't generally altered by lifestyle modifications. If you have a family history of heart disease or if your LDL cholesterol level doesn't respond to drug treatment or to lifestyle changes, talk to your doctor about getting your Lp(a) cholesterol level checked.

In addition to your Lp(a) cholesterol level, your complete cholesterol test, or lipid panel, will include your:

  • Total cholesterol count. Below 200 mg/dL is desirable; 200 to 239 mg/dL is considered borderline high; 240 mg/dL and above is high.
  • Low-density lipoprotein (LDL). Below 70 mg/dL is best if you are at very high risk for heart disease; 100 to 129 mg/dL is near ideal; anything above 130 is considered high.
  • High-density lipoprotein (HDL). HDL is usually referred to as the "good" cholesterol because it keeps your arteries open and your blood flowing more freely. A reading of 60 mg/dL and above is best; below 40 mg/dL for men or below 50 mg/dL for women is considered poor.
  • Triglycerides are another type of fat in the blood and they are often increased by the intake of sweets and alcohol. High levels in your blood raises your risk for heart disease. A reading of below 150 mg/dL is best; 150 to 199 mg/dL is borderline high and 500 mg/dL and above is considered very high.

Depending on your cholesterol levels, your doctor may recommend lifestyle changes, such as quitting smoking, losing weight and exercising at least 30 minutes a day on most days of the week. In addition to lifestyle modifications, your doctor may also prescribe medications, such as statins, to help lower your cholesterol levels.