Key takeaways:
Lipoprotein(a) — or Lp(a) — is a type of cholesterol that can increase your risk for heart disease.
Your Lp(a) level is mainly determined by your genetics. Diet and exercise usually won’t affect Lp(a).
Currently, there are no approved medications to lower Lp(a) levels. But there are several treatments in the pipeline.
The American Heart Association now recommends that all U.S. adults get tested to measure a type of cholesterol called lipoprotein (a) — also known as Lp(a). This test can provide important information about your risk for heart disease. But unlike other types of cholesterol, it’s not so easy to reduce Lp(a) levels.
So, if yours is high, then what? This is a hot topic of research right now. Here, we’ll explain what we currently know about how to lower Lp(a) levels.
What is lipoprotein (a)?
Lp(a) is a type of low-density lipoprotein (LDL) cholesterol, known as the “bad” cholesterol. Lp(a) is especially “sticky” and harmful. And high levels of Lp(a) can cause inflammation inside blood vessels and the heart. This means that it can increase your risk for heart disease, blood clots, and strokes.
But Lp(a) is a little different from other types of cholesterol that are measured in a typical cholesterol blood test. That’s because your Lp(a) level stays fairly consistent throughout your life. Most of the time, high Lp(a) is caused by your genetics. It doesn’t vary with diet and weight changes the way LDL and high-density lipoprotein (HDL) do.
The current research on what reduces lipoprotein(a)
Since Lp(a) levels remain relatively fixed, there has been a lot of research trying to figure out strategies to lower them. Below, we summarize the research about what can — and can’t — reduce Lp(a) levels.
Diet
Most of the research shows that diet doesn’t have a significant impact on Lp(a) levels. But some studies have noticed small changes in Lp(a) when people change the amount and/or type of fat in their diet.
Interestingly, some studies show that a diet low in saturated fat — which is good for your heart — may actually raise Lp(a). But other studies found that increasing the amount of unsaturated (healthy) fats can lower Lp(a).
The role of dietary fat on Lp(a) levels remains unclear. Still, though, increasing unsaturated fats and decreasing saturated fats definitely has an overall positive impact on your cholesterol levels and heart health.
Exercise
Exercise is an important way to lower your risk for heart attack and stroke. But exercise doesn’t affect Lp(a) levels.
Some scientists believe that exercise may reduce the impact of Lp(a) by helping your body to protect itself against this form of cholesterol. But like the other lifestyle changes, there’s still a lot they don’t know.
Weight loss
Weight loss — particularly from dietary changes — is unlikely to lower Lp(a) levels.
There’s evidence that weight loss from bariatric surgery may help lower your Lp(a) level. One analysis of 13 studies found that Lp(a) drops after weight-loss surgery. But other studies looking at weight loss from dietary changes have had different results:
One study found that weight loss with a plant-based diet lowered Lp(a).
Another study of severe calorie restriction found that people had higher levels of Lp(a) with weight loss.
Medications
Currently, there are no approved medications that reduce Lp(a). One medication showed a lot of promise in early clinical trials. But even though it significantly lowered Lp(a) levels, it didn’t reduce major cardiac events like heart attacks. Researchers are still trying to figure out why. And there are several more medications currently in development or in clinical trials.
Lipoprotein apheresis
Currently, the only approved treatment for Lp(a) is a blood-cleaning procedure called apheresis. Unfortunately, this procedure is time consuming and expensive. With apheresis, you’re hooked up to a machine that removes and filters your blood. The process takes several hours, and it’s only offered in a small number of centers.
Supplements
At one time, niacin seemed promising. But research has found that even though niacin lowered the Lp(a) number, it didn’t reduce the likelihood of heart disease. And niacin can have significant side effects.
Some small studies have found a possible benefit of coenzyme Q10 (CoQ10). But more research is needed before this supplement can be recommended.
Lowering LDL cholesterol
Lowering LDL cholesterol won’t lower your Lp(a) levels. Since both types of cholesterol increase your risk for heart disease, some expert organizations have suggested a more aggressive lowering of high LDL cholesterol when someone has high Lp(a). The idea is that lowering LDL even more may offset some of the risk of high Lp(a).
What causes high lipoprotein (a)?
Your level of Lp(a) is mainly determined by your genetics. In fact, 70% to 90% of your Lp(a) number can be traced back to your genes. But several conditions can also affect your numbers.
Conditions that raise Lp(a) are:
Conditions that lower Lp(a) are:
It’s important to note that hormone therapy for menopause isn’t considered a treatment for Lp(a). That’s because experts still don’t know enough about how it might impact heart health.
How is lipoprotein(a) tested?
Lp(a) is a blood test. But it’s not included in your typical cholesterol blood test. It doesn't need to be checked yearly, unless you’re being treated for high levels.
The American Heart Association recommends every U.S. adult get their lipoprotein(a) tested at least once in their lifetime. But it’s especially important to get tested if you:
Have a family history of early heart disease
Had a heart attack or stroke without any known risk factors
Frequently asked questions
Diet alone won’t lower a high lipoprotein(a). But it’s important to eat a heart-healthy diet to help lower your risk of developing heart disease. Focus on whole, nutrient-dense foods. And avoid foods that:
Are high in saturated fat or trans fat
Have added sugar
Are high in salt
Are processed
A good lipoprotein(a) level is anything below 50 mg/dL (or less than 125 nmol/L).
Diet alone won’t lower a high lipoprotein(a). But it’s important to eat a heart-healthy diet to help lower your risk of developing heart disease. Focus on whole, nutrient-dense foods. And avoid foods that:
Are high in saturated fat or trans fat
Have added sugar
Are high in salt
Are processed
A good lipoprotein(a) level is anything below 50 mg/dL (or less than 125 nmol/L).
The bottom line
Your level of lipoprotein (a) — or Lp(a) — is mainly determined by your genetics. Over time, the number usually stays in the same range. This means that lifestyle changes won’t significantly lower a high Lp(a). But choosing a nutritious diet and exercise may help to reduce the potential harm of Lp(a). And new treatments for Lp(a) will likely become available in the next few years.
Why trust our experts?
References
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National Lipid Association. (2026). Top line results from the phase 3 Lp(a)HORIZON trial.
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Sahebkar, A., et al. (2016). Supplementation with coenzyme Q10 reduces plasma lipoprotein(a) concentrations but not other lipid indices: A systematic review and meta-analysis. Pharmacological Research.
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