Understanding lipoprotein(a) and its genetic impact on the heart

Health
September 25, 2025
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16 minutes read

A call for early testing and broader public awareness.

Media webinar titled “Introducing the Little (a) with Big Consequences” warned that one in five people unknowingly carry a genetic risk for heart disease, stressing the urgent need for greater awareness and screening.

Dubai, United Arab Emirates, 24 September 2025

Novartis today convened leading experts from science, policy, patient advocacy, and clinical care to spotlight elevated lipoprotein(a), or Lp(a) – a little-known but highly prevalent genetic risk factor for cardiovascular disease (CVD) that affect 1 in 5 people worldwide.¹

The global educational webinar, titled “Introducing the Little (a) with Big Consequences”, was attended by journalists from leading media publications across the UAE. Held ahead of World Heart Day (29 September 2025), the session was part of a global awareness campaign by Novartis in collaboration with Global Heart Hub to raise awareness of elevated lipoprotein(a) and advance equitable access to testing and care worldwide.

Despite its prevalence, Lp(a) remains underdiagnosed and under-discussed, even though CVD continues to claim nearly 18 million lives annually– more than all cancers combined.^2,3 Elevated levels of Lp(a) are an inherited condition that independently increase the risk of heart attack or stroke.^4,5 To gauge awareness, Novartis recently commissioned a survey across the Asia Pacific and Middle East, which revealed that two in three individuals (66 per cent) skip routine heart tests, while nearly half (45 per cent) are unaware of the genetic link to heart disease. Remarkably, awareness of Lp(a) is even lower, with only seven (7) per cent of respondents reporting they had ever been tested for the biomarker.

“When it comes to our heart health, knowledge is power. The simple and often-overlooked test for Lp(a) is a powerful tool that can empower individuals with life-saving information. This simple blood test can provide a more comprehensive picture of your heart’s health, allowing you and your doctor to take proactive, preventive measures” said Dr. Ronney Shantouf, Staff Physician of Cardiovascular Medicine at Cleveland Clinic Abu Dhabi.”

Highlighting the importance of the webinar, Neil Johnson, Executive Director of Global Heart Hub, noted: “Cardiovascular disease remains the world’s leading cause of death, yet elevated Lp(a), a highly prevalent risk factor, is not even on most people’s radar. That has to change, and the media plays a vital role in putting this hidden risk factor into the global heart health conversation.”

The webinar featured insights from experts including Prof. Gerald Watts, an expert in Cardio-Metabolic Medicine, University of Western Australia, who explained the impact of elevated Lp(a) on cardiovascular health. Nicola Bedlington, Senior Policy Advisor and Project Lead of the Lp(a) International Taskforce, FH Europe Foundation (FHEF), urged policymakers to embed Lp(a) testing into national CVD guidelines to close critical care gaps. She was supported by Zanfina Ademi, Professor of Health Economics at Monash University, who highlighted the cost-effectiveness of Lp(a) testing and its impact on health systems and society.

Meanwhile, regional voices such as Prof. Youngwoo Jang of Gachon University Gil Medical Center; Dr. Rooney Shantouf, of Cleveland Clinic Abu Dhabi; and Dr. A. Sreenivas Kumar of Apollo Hospitals India, discussed the challenges of diagnosis and management in the Middle East and Asia Pacific region. Patient advocate Ram Khandelwal, who survived a heart attack at just 33-years of age, shared his personal journey and the founding of Heart Health India Foundation – a support group raising awareness of elevated Lp(a) among patients.

While awareness of Lp(a) remains low among Asia Pacific and Middle East survey participants, Novartis’ survey shows promise: 58% of respondents expressed interest in genetic testing, signaling a clear opportunity to empower individuals with life-saving knowledge.

“Elevated Lp(a) is a common yet still underestimated – genetic risk factors for cardiovascular disease,” said Mohamed Ezz Eldin, GCC Cluster Head at Novartis. “There is a clear need to increase awareness, encourage routine testing, and foster stronger collaboration across healthcare systems. Early identification allows both individuals and healthcare providers to take informed, proactive steps to protect heart health. At Novartis, we are committed to working with partners across the healthcare and business ecosystem to ensure that people have access to the information and solutions that can help reduce the burden of cardiovascular disease.”

Understanding Lipoprotein(a) and Its Impact on Heart Health

What is Lipoprotein(a)?

Lipoproteins are particles made of proteins to which lipids or fat molecules are attached. Their role is to carry cholesterol and other lipids through the bloodstream and around the body[1].
Lipoprotein(a), often abbreviated as Lp(a) and pronounced “lipoprotein little a” or “L-P-little-a,” is a unique lipoprotein mainly defined by the presence of an added protein called apolipoprotein(a)[2].
This added protein makes Lp(a) particularly ‘sticky’, which can contribute to the build-up of plaque in the arteries[3].

Why is Elevated Lp(a) Critical?

Elevated Lp(a) levels can cause the build-up of fatty deposits in the arteries called plaques, which are known to be an underlying cause of cardiovascular disease (CVD)[4][5][6].
Elevated Lp(a) levels also increase the risk of arterial blood clots forming. These blood clots can block the flow of blood, thus leading to heart attacks, peripheral artery disease, or stroke[7].
Elevated Lp(a) increases the chances of a cardiovascular event, regardless of the presence of other risk factors like hypertension, high cholesterol, diabetes, diet, and exercise[8].
People with elevated Lp(a) could be approximately three times more likely to have a heart attack compared to those with normal levels[9].
Lp(a) levels are approximately 90% genetically determined, are established mainly by the age of 5, and remain relatively consistent over a lifetime – this means they are passed from parents to their children [10],[11].

Prevalence and Testing

Approximately one in five people worldwide have elevated Lp(a) levels but may not know unless they get tested[12].
Institutions such as the European Atherosclerosis Society recommend that Lp(a) levels should be measured at least once in all adults using a routine, non-fasting blood test as part of general heart health checks[13].
Testing for elevated Lp(a) is particularly recommended for individuals with a family history of premature cardiovascular events, genetic dyslipidemia, or aortic stenosis[14].

Managing Elevated Lp(a)

It is important to discuss elevated Lp(a) levels with a healthcare professional to determine the next course of action, which may include being referred to a specialist[15].

[1] Cleveland Clinic. Lipoproteins [Internet]. Cleveland Clinic; [cited 2025 May 26]. Available from: https://my.clevelandclinic.org/health/articles/23229-lipoprotein

[2] Marcovina SM & Albers JJ. J Lipid Res. 2016;57(4):526–537

[3] Cox RA, Garcia-Palmieri MR. Cholesterol, triglycerides, and associated lipoproteins. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory

[4] Tasdighi E, et al. Annu Rev Pharmacol Toxicol. 2024;64:135–157

[5] Vinci P, et al. Int J Environ Res Public Health. 2023;20(18):6721

[6] Degrell P, et al. Arch Cardiovasc Dis. 2015;108(12):675–682

[7] American Heart Association. Lipoprotein (a) Meaning and How Does it Impact My Heart Health? [Internet]. American Heart Association; [cited 2025 May 26 2025]. Available from: https://www.heart.org/en/health-topics/cholesterol/genetic-conditions/lipoprotein-a-risk

[8] Kronenberg F. Cardiovasc Drugs Ther. 2016;30(1):87–100

[9] Kamstrup PR, et al. JAMA. 2009;301(22):2331–2339

[10] Tsimikas S. A test in context: lipoprotein(a): diagnosis, prognosis, controversies, and emerging therapies. J Am Coll Cardiol. 2017;69(6):692–711.

[11] Wilson, D. P., Jacobson, T. A., Jones, P. H., Koschinsky, M. L., McNeal, C. J., Nordestgaard, B. G., & Orringer, C. E. (2019). Use of Lipoprotein(a) in clinical practice: A biomarker whose time has come. A scientific statement from the National Lipid Association. Journal of clinical lipidology, 13(3), 374–392.

[12] Rendler J, et al. Health Care Curr Rev. 2024;12(2):397

[13] Frequent questions and responses on the 2022 lipoprotein(a) consensus statement of the European Atherosclerosis Society. Atherosclerosis, 374, 107–120.

[14] Kronenberg F. Clin Res Cardiol Suppl. 2019;14(Suppl 1):5–12

[15] Boerwinkle E, et al. J Clin Invest. 1992;90(1):52–60