Scientists Say Everyone Should Get This Simple Blood Test—and You’ve Probably Never Heard of It

New research suggests that everyone should have their lipoprotein(a) levels tested—but what is that?

Reviewed by Dietitian Jessica Ball, M.S., RD

Key Points

• New guidelines recommend a more comprehensive, long-term view of heart health.
• Dyslipidemia—abnormal lipid levels—plays a central role in heart disease risk.
• Researchers recommend everyone have their lipoprotein(a) levels tested to assess heart health.

When it comes to healthcare, a single snapshot rarely tells the whole story. What matters more is what’s happening over time. Take glycated hemoglobin (HbA1c) for example—the HbA1c test revolutionized the way we diagnose and manage diabetes because it reflects average blood sugar over the past three months, rather than one singular moment in time.

Heart health is starting to be viewed through a similar lens. While LDL cholesterol levels have long been a cornerstone for assessing cardiovascular disease risk, experts now recognize that one number alone doesn’t fully capture the bigger picture—especially when risk can build up silently over decades.

This matters because heart disease risk is often shaped by modifiable lifestyle factors, in addition to dyslipidemia—a condition defined by abnormal levels of lipids like cholesterol and triglycerides—which plays a central role. Dyslipidemia is often considered a silent threat, as it typically doesn’t cause noticeable symptoms. Still, it can significantly increase the risk of heart disease over time.

And though we once thought a simple snapshot of LDL cholesterol levels was enough to identify and manage abnormal lipid levels, relying on a single measurement may not tell the full story. Researchers are increasingly focused on understanding lifetime lipid levels through additional lab tests to help uncover hidden risk.

This shift is reflected in a recent update to guidelines from the American Heart Association and American College of Cardiology, published in Circulation. The new guidance places greater emphasis on lifetime cardiovascular risk and a more comprehensive approach to lipid testing—including a one-time measurement of lipoprotein(a), or Lp(a), a lesser-known biomarker that can significantly influence your heart disease risk.

What to Know About the New Guidelines

The goal of the new guidelines in Circulation is to address the evaluation, management and monitoring of patients with dyslipidemias—which includes high cholesterol, hypertriglyceridemia and elevated Lp(a). Interestingly, this updated guideline includes a much wider scope than the previous guidelines to reflect the evolving understanding of heart disease risk.

To update the recommendations effectively, researchers conducted a comprehensive review of existing evidence, including clinical trials, systematic reviews and meta-analyses focused on how dyslipidemia is evaluated, treated and monitored.

After identifying the most relevant research, a multidisciplinary writing committee was assembled to interpret the findings and develop recommendations. The group included general cardiologists, internal medicine specialists, primary care physicians, geriatricians, clinical lipid specialists, a cardiothoracic surgeon, advanced practice nurses, clinical pharmacists, a registered dietitian and a patient advocate—bringing together a wide range of perspectives.

What Did Experts Recommend?

Among various updates made to the previous guideline, the American Heart Association and the American College of Cardiology emphasized that these recommendations are meant to guide care for most people—but not to replace clinical judgement. In other words, they’re a framework, not a one-size-fits-all rulebook.

Though there were various important takeaways, a few key themes stood out.

Start Prevention Earlier

Instead of waiting until lipid levels are significantly elevated or abnormal, the guidelines emphasize starting prevention earlier. This includes an emphasis on healthy lifestyle behaviors—like diet, physical activity and other healthy habits—beginning in childhood and young adulthood to help reduce long-term risk for heart disease.

Risk Assessments Are More Robust

The previous heart health risk assessment tools are getting an upgrade. The guidelines recommend using the American Heart Association’s PREVENT tool to better estimate cardiovascular risk and guide decisions around lipid-lowering therapy, as the tool can project an individual’s 10-year and 30-year risk. The shift here is toward a more personalized and nuanced risk evaluation to help guide decisions about starting medication.

Other Biomarkers Matter, Too

While LDL cholesterol levels remain important, it’s no longer the only lab test worth paying attention to. The guidelines specifically recommend measuring lipoprotein(a), or Lp(a), levels at least once in an individual’s lifetime.

Lp(a) is a cholesterol-carrying lipoprotein in your blood, and your Lp(a) level is mostly genetically determined. Because your level is inherited and relatively stable over a lifetime, the test usually needs to be done just once, preferably in early adulthood. Getting levels checked requires a simple blood test that’s widely available. When levels are high (≥125 nmol/L or ≥50 mg/dL), it points to an increased risk of heart disease.

Currently, a regular cholesterol test—or lipid panel—doesn’t measure Lp(a). However, about one in five adults have high levels without many noticeable symptoms.

Statins Still Have a Place

Despite the growing focus on additional lab tests and individualized risk, statins remain the foundation of treatment for managing high cholesterol and reducing heart disease risk.

For individuals who need additional support, other lipid-lowering therapies may be considered—but statins are still typically the first-line approach.

How Does This Apply to Real Life?

These updated guidelines reflect a broader shift in how we think about heart health. The biggest takeaway? Lifetime exposure to risk matters more than a single snapshot. In other words, it’s not just how high your LDL cholesterol is today—it’s how long your arteries have been exposed to it over time.

So what does that actually mean for you? For starters, a one-time Lp(a) test may be worth discussing with a healthcare provider—especially for individuals with a family history of heart disease. Because Lp(a) is largely genetically determined, it can help uncover hidden risk that wouldn’t show up on a standard lipid panel.

Beyond lab tests, the basics still matter. The American Heart Association continues to emphasize its Life’s Essential 8—a set of lifestyle factors that support heart health, including a balanced diet, regular physical activity, quality sleep and routine preventive care.

Overall, the updated guidelines reinforce a simple but important idea: a more complete picture of your risk—combined with small, consistent healthy habits—can make a meaningful difference in long-term heart health.

Our Expert Take

The American Heart Association and the American College of Cardiology’s updated clinical practice guidelines reflect a meaningful shift in how we approach heart health—moving beyond a narrow focus on cholesterol alone and toward a more comprehensive view of dyslipidemia and long-term risk.

While consistent lifestyle habits still play a central role in supporting heart health, these guidelines expand the conversation to include more individualized lab testing. If you’ve never had your Lp(a) level checked, it may be worth speaking to a healthcare provider about it—especially if you have a family history of heart disease. Adding in biomarkers like Lp(a) can help uncover risks that may otherwise go unnoticed.

At the end of the day, it’s about getting a clearer, more complete picture of your health so you can take action sooner, rather than later.