A sweeping new international study has reinforced the dangers of elevated lipoprotein(a) – called Lp(a) – showing that any detectable increase in this cholesterol-like molecule is linked to greater risk of heart disease and stroke. The findings, widely reported as the largest investigation of its kind to date, signal a major shift in how health professionals may assess and manage cardiovascular risk, especially in populations such as Thailand where heart disease remains the country’s leading cause of death.
Lipoprotein(a), often abbreviated as Lp(a) and pronounced “L-p-little-a,” is a type of particle found in the blood, similar to LDL or “bad cholesterol,” but with an additional protein that makes it uniquely sticky and more likely to promote blood clots and arterial plaque. Unlike cholesterol, Lp(a) levels are largely determined by genetics and little affected by lifestyle or common cholesterol-lowering therapies. For decades, Lp(a) has been a somewhat underappreciated risk factor, but the sheer scale of the new research, spanning hundreds of thousands of participants, makes clear that even modest elevations need clinical attention (medicalxpress.com).
The study, presented in early May 2025, analyzed Lp(a) levels in participants from different geographic, ethnic, and age backgrounds, and followed them over time for incidents of heart attacks, strokes, and related cardiovascular events. The evidence was clear: compared to those with the lowest Lp(a) levels, people with any measurable increase faced a higher likelihood of experiencing cardiovascular disease. Notably, the risk rose steadily with higher Lp(a) concentrations but started climbing even at relatively low thresholds, suggesting that prior “normal” cut-off values may have been too high (medicalxpress.com).
This discovery is particularly relevant for Thailand. According to the Department of Disease Control, cardiovascular disease accounts for roughly 20% of all deaths in Thailand each year, and trends show an uptick related to hypertension, diabetes, obesity, and urban lifestyle changes (who.int). However, while Thai hospitals are sophisticated in screening for LDL, HDL, and triglycerides, routine Lp(a) measurement is rare and not part of standard health checkups. Thai cardiology experts stress that these findings should prompt a reevaluation of how heart risk is screened locally. One cardiologist from a leading Bangkok hospital emphasized, “This research compels us to expand our focus beyond traditional cholesterol metrics. Lp(a) should be measured, especially in individuals with a personal or family history of heart disease, even if standard cholesterol levels appear normal.”
Globally, up to one in five people may have genetically elevated Lp(a), but awareness remains low. Standard lifestyle changes – such as improved diet, regular exercise, and smoking cessation – are always recommended, but they have little if any effect on Lp(a) levels. Currently, very few treatments exist for lowering Lp(a), though new drugs are under development and in late-stage trials (nih.gov), offering hope for high-risk patients identified through population-wide screening.
For Thai patients and families with a history of premature coronary artery disease – heart attacks, stroke, or clogged arteries occurring before age 55 in men or 65 in women – health specialists now recommend discussing Lp(a) testing with their doctors. The Thai Society of Cardiology has yet to formally include Lp(a) checks in national guidelines, but international best practices increasingly support doing so for high-risk groups.
Although only a small segment of the Thai population currently accesses advanced lipid testing, awareness is growing – especially among health-conscious urban residents and the expanding private health sector. It’s important for Thais to recognize that even in the absence of high LDL or high blood pressure, a silent risk may lurk in Lp(a) – underscoring a broader theme in Thai healthcare: genetic factors matter as much as lifestyle.
Medical historians point out that Southeast Asian populations have unique lipid profiles, with comparatively lower average cholesterol but sometimes higher rates of stroke and certain hereditary heart conditions. In Thailand, where family ties and intergenerational living are common, opportunities for early risk detection through family-linked genetic screening could become an important tool in long-term disease prevention.
Looking ahead, the Thai Ministry of Public Health may need to consider incorporating Lp(a) measurement into state-sponsored health screenings, especially as new therapies become available. Public information campaigns – perhaps delivered via popular social media channels and rural clinics – could educate Thais about non-modifiable versus modifiable risk, helping individuals make informed choices about their heart health.
Until such changes are codified, Thai readers can take practical steps: ask your healthcare provider about your full cholesterol profile, particularly if you have a family history of cardiovascular issues; advocate for advances in genetic and lipid screening; support ongoing research and innovation in Thai cardiovascular medicine; and, most importantly, continue living a heart-healthy lifestyle to minimize other sources of risk even if your Lp(a) cannot be easily reduced.
For more information, readers can consult the original coverage on Medical Xpress and look for updates from local health authorities as new screening recommendations emerge.