Hidden Genetic Heart Risk May Affect One in Five People, Study Finds - Video

That "normal" cholesterol report might be hiding a genetic troublemaker.

A large analysis of more than 20,000 adults suggests that elevated Lipoprotein(a), or Lp(a), may quietly increase the risk of serious cardiovascular problems—even when traditional cholesterol levels appear acceptable.

Presented at the SCAI 2026 Scientific Sessions and CAIC-ACCI Summit, the findings analyzed participants from three major NIH trials: ACCORD, PEACE and SPRINT. Researchers measured Lipoprotein(a), a cholesterol-carrying particle that resembles LDL but contains an additional protein that can make it more likely to contribute to artery disease.

Unlike ordinary cholesterol, Lipoprotein(a) levels are largely inherited. Around one in five people may have elevated levels, yet most are unaware because high Lipoprotein(a) usually causes no obvious symptoms.

Researchers examined 20,070 participants aged 40 and older, tracking major adverse cardiovascular events such as heart attack, stroke, coronary revascularization and cardiovascular death over a median of nearly four years.

The strongest warning signal appeared in people with Lipoprotein(a) levels of 175 nmol/L or higher. This level was independently associated with a 31% higher risk of major cardiovascular events, a 49% higher risk of cardiovascular death, and a 64% higher risk of stroke. However, researchers found no significant increase in heart-attack risk at this threshold.

The researchers emphasize that Lipoprotein(a) can reveal hidden cardiovascular risk that standard cholesterol testing may miss. Because levels are largely genetic and can be measured with a simple blood test, testing may help identify people who need more aggressive management of other risk factors, particularly LDL cholesterol.

Still, elevated Lipoprotein(a) does not mean a cardiovascular event is inevitable. Researchers say the findings support greater awareness and risk management while targeted Lipoprotein(a) lowering treatments continue to emerge.

REFERENCE: Subhash Banerjee et al., “Lipoprotein(a) Identifies Residual Cardiovascular Risk in NIH Randomized Trials”; 2026, SCAI 2026 Scientific Sessions; https://scai.confex.com/scai/2026/meetingapp.cgi/Paper/46023