UCSD - University of California - San Diego

10/08/2026 | Press release | Distributed by Public on 10/08/2026 09:34

Have You Had Your Lp(a) Levels Checked

Published Date

October 08, 2026

Article Content

An estimated one in five people has elevated levels of lipoprotein(a), or Lp(a), an inherited risk factor for cardiovascular disease that can significantly increase the likelihood of heart attack and stroke. Yet despite its prevalence, testing for Lp(a) remains low.

Now, with an independent grant from Eli Lilly and Company to the University of California San Diego, researchers are launching an effort to help change that.

The multidisciplinary team with researchers from UC San Diego and UC Irvine will test a novel, multipronged approach to increase Lp(a) testing among adults who have not yet developed cardiovascular disease. The goal is to identify heart disease risk earlier, allowing clinicians to preventative take steps to reduce patients' chances of having a heart attack or stroke.

"Elevated Lp(a) represents an important and often unrecognized contributor to cardiovascular risk," said Ehtisham Mahmud, MD, executive director of the Cardiovascular Institute at UC San Diego Health and chief of the Division of Cardiovascular Medicine at UC San Diego School of Medicine. "This study reflects the UC San Diego Health Cardiovascular Institute's commitment to advancing prevention efforts by bringing research to clinical care for the benefit of patients. What we learn through this collaboration will extend well beyond our own health system."

The study comes at a pivotal moment. Updated national guidelines released in 2026 recommend that Lp(a) be measured at least once in adulthood, reflecting growing recognition of the role elevated Lp(a) plays in cardiovascular disease.

Unlike many traditional cardiovascular risk factors, Lp(a) levels are largely genetically determined and generally remain stable throughout a person's life. For most adults, that means a single blood test can provide information that may help clinicians better understand a patient's lifetime cardiovascular risk.

Michael Wilkinson, MD

"Guidelines are increasingly clear that adults should have Lp(a) measured, but the question is how we make that happen consistently in busy, real-world clinical settings," said Michael Wilkinson, MD, associate professor of medicine at UC San Diego School of Medicine, director of the Advanced Lipid Disorders Treatment Program at UC San Diego Health and principal investigator of the study. "Our goal is to identify practical strategies that help clinicians recognize who has not been tested, make testing easier to incorporate into care and ultimately develop an approach that other health systems can adopt."

While there is not yet a U.S. Food and Drug Administration-approved therapy specifically indicated to lower Lp(a), knowing that a patient has elevated levels can inform their care. Clinicians can more aggressively address modifiable cardiovascular risk factors, including LDL cholesterol and blood pressure, and consider additional evaluation or specialist referral when appropriate. Therapies specifically targeting Lp(a) are also being evaluated in clinical trials.

"Lp(a) has been overlooked for far too long, particularly given how common elevated levels are among the general population, and how valuable that knowledge can be to treating and preventing heart disease," said Pam Taub, MD, director of the UC San Diego Bioinformatics, Epidemiology, and Lp(a) Center for Research and Innovation (BEACON) and director of Preventive Cardiology at UC San Diego Health. "One of BEACON's central goals is to move Lp(a) research into clinical practice."

Moving from guidelines to everyday care

The 18-month study will involve primary care and specialty clinicians at UC San Diego Health and UC Irvine and is expected to encompass approximately 12,000 patients across the two health systems.

Researchers will evaluate a combination of strategies designed to make Lp(a) testing easier to incorporate into routine clinical practice. These include clinician education; targeted electronic health record tools to identify patients who may benefit from testing; and personalized feedback that allows clinicians to see their own Lp(a) testing patterns in comparison with peers and recommended practice.

Clinics will be randomized to evaluate which approaches are most effective. The feedback component is informed by principles of behavioral economics and will examine whether giving clinicians relevant, actionable information about their own practice patterns can help accelerate adoption of recommended testing.

The study will focus on adults without established cardiovascular disease, providing an opportunity to identify elevated risk before a heart attack, stroke or other cardiovascular event occurs. Primary care physicians are particularly important to the effort because they are often best positioned to identify risk earlier in a patient's life.

Researchers will also explore an innovative strategy to identify patients who may warrant additional cardiovascular risk assessment by leveraging artificial intelligence technology to detect coronary artery calcium visible on certain chest CT scans performed for other medical reasons. When substantial coronary plaque is identified, clinicians participating in the study may receive information prompting them to consider Lp(a) testing and other appropriate cardiovascular evaluation.

Ming Tai-Seale, PhD, MPH, professor of family medicine at UC San Diego School of Medicine and co-principal investigator of the study, said the project is designed to address a challenge that extends far beyond Lp(a).

"We know that providing clinicians with new evidence or education alone does not always lead to changes in practice," said Tai-Seale. "By studying how tools such as clinical decision support and individualized feedback influence behavior, we can better understand how to close the gap between what guidelines recommend and what happens in everyday patient care. That knowledge could have applications well beyond Lp(a) testing."

Scaling a testing model nationwide and beyond

The project builds on UC San Diego's growing leadership in Lp(a) research through BEACON, which brings together experts in preventive cardiology, lipid disorders, epidemiology, bioinformatics and data science to advance understanding of Lp(a) and improve patient care.

Wilkinson, who serves on the National Lipid Association Board of Directors, recently co-authored research highlighting the need to improve Lp(a) testing and address barriers that have limited its adoption in clinical practice.

The new study takes that work a step further by evaluating an intervention across two academic health systems. By testing the strategies simultaneously at UC San Diego Health and UC Irvine, researchers hope to determine which approaches are effective across different clinical environments - a critical step toward broader adoption.

"Demonstrating whether these interventions work in two different health systems will give us a strong foundation for expanding these methods to other institutions," Wilkinson said. "The larger goal is to make identifying elevated Lp(a) a routine part of patient care, so that patients and their clinicians have this information before a cardiovascular event occurs."

If successful, researchers plan to build on the findings through studies involving additional health systems and larger patient populations.

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