Ground-Breaking International Study on Lp(a) Testing Cost Effectiveness

A Hidden Heart Risk Affects 1 in 5 – And a Simple Blood Test Could Help Stop It

A new study* shows routine testing for a little-known cardiovascular threat could prevent heart attacks, strokes, and save millions in health costs.

Most people have heard of cholesterol. But there’s another dangerous lipid in the blood – lipoprotein(a), or Lp(a), which if high in levels, could be silently putting millions at risk.

An international study led by Professor Zanfina Ademi and her Team at Monash University (Melbourne, Australia) reveals the cost effectiveness of testing high levels of Lp(a), a genetic and lifelong risk factor for heart disease affecting nearly 1 in 5 adults.

“This is one of the biggest blind spots in heart health,” said Professor Zanfina Ademi, a health economist and senior author of the study. “You can have a healthy lifestyle and normal cholesterol, but if your Lp(a) is high, you’re still at serious risk.”

Cardiovascular disease remains the world’s leading cause of death. In Australia, it costs over $14 billion a year; in Europe, that number soars to €282 billion. Yet Lp(a), which cannot be improved by diet or exercise, is not part of routine testing in most healthcare systems.

Published in Atherosclerosis, the study analysed data from over 10,000 adults in the UK. The results were striking: routine Lp(a) testing would have reclassified 20% of participants as high-risk, leading to earlier intervention with blood pressure or cholesterol-lowering medications.

In the same issue, Prof. Jan Boren, Editor-in-Chief of Atherosclerosis, issues a call to action in an editorial**, urging guideline developers and policymakers to act: “When a simple blood test can help prevent life-threatening cardiovascular events and improve quality of life, all in a cost-effective way, implementing such testing isn’t just advisable, it’s imperative”.

The modelling showed that, testing could prevent 60 heart attacks, 13 strokes and 26 early deaths (per 10,000 people tested).  While adding 217 years and 255 years of healthy life – all while saving approximately $85 and £263 per person in Australia and in the UK respectively in medical and productivity costs. Researchers tested this approach in nine high income countries and found the same result everywhere: regularly testing for Lp(a) could save money in all their healthcare systems.

“This is a game-changer,” said Professor Florian Kronenberg of the Medical University of Innsbruck, Chair of the Lp(a) International Taskforce. “A one-time test could prevent countless tragedies and is one of the most cost-effective tools we have.”

The research helped inform the Brussels International Declaration on Lp(a) Testing and Management, a new global policy roadmap calling for Lp(a) to be included in national cardiovascular screening programs.

Magdalena Daccord, CEO of FH Europe and co-author of the study, said: “Most people think they’re safe if their cholesterol is normal. But Lp(a) is often the missing piece. This simple test can save lives. The science is here – now it’s time to act.”

Commissioned by the Lp(a) International Taskforce and hosted by the FH Europe Foundation (FHEF), this patient-driven research initiative was led by the Centre for Medicine Use and Safety at the Monash Institute of Pharmaceutical Sciences, in collaboration with global researchers and the Lp(a) International Taskforce. The study forms part of a broader multistakeholder effort to advance understanding and action on Lp(a).

* Lp(a) testing for the primary prevention of cardiovascular disease in high-income countries: a cost-effectiveness analysis. Jedidiah I Morton, Florian Kronenberg, Magdalena Daccord, Nicola Bedlington, Marius Geantӑ, Tobias Silberzahn, Zhenyue Chen, Jean-Luc Eiselé, Bogi Eliasen, Mariko Harada-Shiba, Marc Rijken, Albert Wiegman, George Thanassoulis, Pia R Kamstrup, Iñaki Gutiérrez-Ibarluzea, Pablo Coral, Raul D Santos, Erik Stroes, Michal Vrablík, Gerald F Watts, Christie M Ballantyne, Samia Mora, Børge G Nordestgaard, Kausik K Ray, Stephen J Nicholls, Zanfina Ademi, On behalf of the Lp(a) International Taskforce (ITF) initiative.

Why the Safe Hearts Plan matters on Lp(a) Awareness Day?

On Lp(a) Awareness Day, we highlight the importance of early detection and prevention of elevated lipoprotein(a), a common but often overlooked inherited risk factor for cardiovascular disease. Lp(a) levels are largely determined by genetics, remain stable throughout life, and are not detected in standard cholesterol tests – making targeted, one-time testing essential.

High Lp(a) can significantly increase the risk of heart attack, stroke, and aortic valve disease, even in otherwise healthy individuals. Because it is present from birth, early identification allows for timely risk assessment and preventive measures to reduce long-term cardiovascular damage.

The European Commission’s Safe Hearts Plan, published in December 2025, is the first EU-wide initiative to take a comprehensive approach to cardiovascular disease. Crucially, it explicitly recognises elevated Lp(a) as a key inherited risk factor. By promoting early-life screening, personalised prevention, and improved awareness, the Plan creates a real opportunity to identify individuals at risk sooner and intervene before serious disease develops.

In the context of Lp(a) Awareness Day, the Plan reinforces that early identification and intervention are not just best practice – they can be lifesaving. It sets a clear direction for Europe to move from reactive, late-stage treatment to proactive, lifelong cardiovascular care.