If you have high Lp(a), like me, here are 5 things you need to know to protect your heart:

1. Lp(a) is mostly genetic. While it can be influenced at the margins (e.g. inflammation), most people have a genetic “floor.” I inherited mine from my father. Do you know yours?

2. Your genes may be fixed—but your jeans aren’t. Specifically, visceral fat matters. People with low waist-to-hip ratios, a proxy for less visceral fat, often show little to no added cardiovascular risk from high Lp(a).

Why? Because Lp(a) interacts with the metabolic environment.

3. Medications matter. Statins can increase Lp(a), while PCSK9 inhibitors tend to decrease it.

4. Vitamin C may help reduce the atherogenicity of Lp(a) by working inside the lumen of blood vessels and inside artery walls

5. Ketogenic diets may also reduce Lp(a)-related risk—working inside the artery to lower inflammation, oxidative stress, and depletion of key cofactors caused by Lp(a).

This is the Cliff Notes version.

For the full deep dives—10,000+ words of nuance, mechanisms, and references—check the comments & StayCurious .