The Cholesterol Number You've Never Been Tested For
Canada has a heart health blind spot — and it may be sitting quietly in your bloodstream right now.
Researchers and cardiologists are raising the alarm about Lipoprotein(a), commonly written as Lp(a), a type of cholesterol particle that significantly raises the risk of heart attack and stroke. The catch? About one in five Canadians carry elevated levels of it, and almost none of them know.
Unlike high blood pressure or elevated LDL cholesterol, Lp(a) shows no outward symptoms. You won't feel it. It doesn't show up on a standard cholesterol panel. And there is currently no routine screening for it in Canada — meaning millions of people walking into a doctor's office thinking they're perfectly healthy could be carrying a significant, undetected cardiovascular risk.
Why It Matters — Especially for 'Healthy' People
Lp(a) has long puzzled cardiologists because it helps explain something that's deeply unsettling: why seemingly healthy people — fit, non-smokers, with normal cholesterol — have heart attacks anyway.
The particle is almost entirely determined by genetics. Diet and exercise have very little effect on your Lp(a) levels. If your parents had elevated Lp(a), there's a good chance you do too. It's not a lifestyle problem; it's a hereditary one.
For people with high levels, the risk of a cardiovascular event — a heart attack, stroke, or aortic valve disease — can be substantially elevated compared to those with normal levels. The frustrating part is that this information is entirely knowable with a single blood test that most Canadians have simply never been offered.
Experts Are Pushing for Change
Cardiovascular researchers and patient advocates have been pushing Canadian health authorities to make Lp(a) testing a standard part of adult cardiac screening, similar to how blood pressure checks and basic cholesterol panels are routine today.
The argument is straightforward: if you know you have high Lp(a), you and your doctor can take more aggressive steps to manage the other risk factors you can control — LDL cholesterol, blood pressure, inflammation, and lifestyle habits — to offset the inherited risk.
There is also genuine hope on the treatment front. Several drug companies are in late-stage clinical trials for medications that directly target and lower Lp(a) levels. If those trials succeed, having a baseline screening program already in place would allow Canada to quickly identify the millions of patients who could benefit.
What You Can Do Right Now
If you have a family history of heart disease — particularly in first-degree relatives who had heart attacks or strokes at a relatively young age — it's worth asking your doctor about an Lp(a) test specifically. In many provinces, the test is available and covered, but it simply isn't ordered unless requested.
Awareness is the first step. The medical community largely agrees that Lp(a) is an underappreciated risk factor, and the push for universal screening is growing. Getting tested won't eliminate the risk, but it gives you and your healthcare team a much clearer picture.
Your heart may be working fine right now — but knowing your numbers has never been more important.
Source: CBC News Health. Original reporting by CBC Top Stories RSS.
