Nathaniel Lebowitz, MD, is an attending cardiologist at the Hackensack University School of Medicine and an assistant professor of internal medicine at the Hackensack Meridian School of Medicine.

Nathaniel Lebowitz, MD

 and its risks is currently subpar, a recent program from the American Heart Association (AHA) has shown the promise of educational initiatives to help both clinicians and patients become knowledgeable about this risk.

AHA Publishes Results of Nationwide Initiative for Lp(a) Education and Awareness

Lp(a), among the leading contributors to 

atherosclerotic cardiovascular disease (ASCVD)

, is still largely underrecognized and untested in clinics nationwide. Previous research has shown a significant causal effect on atherosclerosis and major adverse cardiovascular events due to elevated Lp(a). Roughly 1 in 5 individuals has elevated Lp(a), and its substantial basis in genetics highlights the critical need for cascade screening in families.

The recent ACC/AHA guidelines for dyslipidemia treatment specifically recommend that every US adult have their Lp(a) levels measured ≥1 time in their lives. Should elevated Lp(a) be detected, the guidelines go on to emphasize cascade screening to determine whether parents, siblings, and children exhibit the same condition. However, despite the guidelines’ release in March 2026, Lp(a) screening is still woefully low, leaving many patients unaware of the significant cardiovascular risk they have inherited.

“Because guidelines are slow to permeate, and it hasn’t been in the guidelines as a mandate for too long, education hasn’t really permeated, best practices haven’t permeated,” Nathaniel Lebowitz, MD, an attending cardiologist at the Hackensack University School of Medicine and an assistant professor of internal medicine at the Hackensack Meridian School of Medicine, told 

 in an exclusive interview. “However, it has been in the guidelines in the sense that when there’s a family history of premature coronary disease, that it should be tested.”

To address this, the AHA initiated the Lp(a) Discovery Project, aiming to better understand clinic-level practice patterns for these patients and to develop scalable national models for testing. The initiative lasted 3 years and recruited 10 health systems with established Lp(a) screening processes – a cardiology clinic champion and stakeholders from each system were consulted quarterly regarding Lp(a) screening pathways, evaluation, and management, as well as possible barriers in each step. This group convened quarterly to discuss strategies and educational initiatives.

The AHA then implemented the data collected from the initiative through the Get With The Guidelines-Stroke (GWTG-Stroke) and Get With The Guidelines-Coronary Artery Disease (GWTG-CAD) registries, which are both national in-hospital approaches to improving patient outcomes across their respective focus areas. Data were extracted from both initiatives and analyzed based on Lp(a) value, Lp(a) unit, the presence or absence of Lp(a) values, lipid-lowering therapy at discharge, and Lp(a) treatment plans.

Of the 761,748 patients in GWTG-CAD, only 2790 (0.3%) had Lp(a) tests on record. Additionally, of the 9,671,350 patients in GWTG-Stroke, only 7626 (<.001%) had Lp(a) tests. Median age among these patients was 67 years (interquartile range [IQR], 21 years) for GWTG-Stroke and 61 years (IQR 18) in GWTG-CAD. Patients in GWTG-CAD presented with a median Lp(a) of 79.2 (IQR 164) nmol/L, while GWTG-Stroke had a median Lp(a) of 67.2 (IQR 117.6) nmol/L. However, only 8.5% of patients evaluated in GWTG-Stroke were educated on Lp(a), while 5.43% were referred for lipid management. In GWTG-CAD, 7.7% were educated, and 14% were referred for lipid management.

Based on these data, the initiative developed and implemented a comprehensive educational plan in the form of a webinar series describing the mechanisms of Lp(a) and its role as an independent and causal cardiovascular risk factor. A focus group comprised of 52 patients with elevated Lp(a) was also assembled to discuss lived experiences with Lp(a) – this revealed that many primary care clinicians were unfamiliar with Lp(a), and many individuals only discovered their elevated status after a cardiovascular event.

Post-webinar surveys ultimately demonstrated significant improvements in self-reported Lp(a) knowledge and clinical application. The programs have amassed >100,000 views, and the accompanying patient resources have passed 82,000 downloads. Based on these examples, the creators of the project ultimately concluded that educational resources must be disseminated across various channels to reach broader audiences, providing both clinicians and patients with the knowledge of Lp(a) and its potential cardiovascular risk.

“It’s going to take initiative from the cardiologists and the endocrinologists and the lipidologists within an institution to understand and start working on institutionalized best practices, because now it’s very clear that it’s in the guidelines,” Lebowitz said. “I predict that it’ll really take off much more as new drugs hit the market, because very often, they’ll go straight to the consumer.”

Editors’ Note: Lebowitz reports no relevant disclosures.

Shah NP, Gao Z, Li S, et al. American Heart Association lipoprotein(A) Discovery project: A national initiative to advance awareness and lipoprotein(A) testing for patients with cardiovascular disease. 

American Journal of Preventive Cardiology

Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APHA/ASPC/NLA/PCNA guideline on the management of dyslipidemia: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153(17). 

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Lp(a) is one of the biggest contributors to cardiovascular disease, but recent studies have shown that awareness of and testing for the condition is subpar nationwide.

Nathaniel Lebowitz, MD

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