Lipoprotein(a) testing prevalence remains just 1.1% in US adults

A Family Heart Database analysis found lipoprotein(a) [Lp(a)] testing prevalence was just 1.1% among US adults, while a companion at-home screening program identified elevated LDL-C and/or lipoprotein(a) levels in nearly two-thirds of results returned.^1,2

Current dyslipidemia guidelines recommend lipoprotein(a) measurement at least once during adulthood, yet adoption of universal testing has lagged. In data presented at the 10th Annual Heart in Diabetes meeting, the Family Heart Foundation examined both sides of this gap: how often lipoprotein(a) is ordered in routine claims data, and what happens when free at-home testing removes the access barrier.^1,2,3

Lp(a) testing prevalence and racial disparities

Investigators analyzed the Family Heart Database, a claims and laboratory repository spanning 350 million US individuals from 2012 to 2024, to assess Lp(a) testing prevalence in adults tested during 2023 to 2024. Among all adults in the cohort (2,063,830 of 187,594,288), Lp(a) testing prevalence was 1.1%.²

Prevalence rose to 2.6% among adults with a standard lipid profile, 2.8% among those with established atherosclerotic cardiovascular disease (ASCVD), and 5.7% among adults with both ASCVD and a lipid profile on record.²

Diabetes (adjusted odds ratio [aOR], 0.78; 95% CI, 0.78 to 0.79; P < .0001) and stage III to V chronic kidney disease (aOR, 0.88; 95% CI, 0.87 to 0.89; P < .0001) were both associated with lower odds of Lp(a) testing relative to adults without those conditions. Greater Charlson Comorbidity Index scores followed a similar inverse pattern, with adults carrying a comorbidity index of 8 or more 26% less likely to be tested than those with no comorbidities (aOR, 0.74; 95% CI, 0.72 to 0.75; P < .0001).²

Repeat testing occurred in 25.1% (517,125 of 2,063,830) of adults with an initial Lp(a) result. In multivariable regression, familial hypercholesterolemia carried the strongest independent association with testing (aOR, 2.44; 95% CI, 2.38 to 2.49; P < .0001), followed by high LDL-C, non-statin lipid-lowering therapy, established coronary artery disease, and age over 40 years. White adults were 87% more likely to undergo Lp(a) testing than Black adults (aOR, 1.87; 95% CI, 1.85 to 1.88; P < .0001), a disparity investigators flagged as a target for intervention.²

Cholesterol Connect At-Home Screening

The Family Heart Foundation launched Cholesterol Connect in September 2024 to provide free at-home LDL-C and Lp(a) screening paired with Care Navigator support. According to the study, kit orders reached 30,950 through March 2026, outpacing the program's original projections. Among the first 8675 kits with results, 41% (3556) showed elevated LDL-C alone, 13% (1096) showed elevated LDL-C and Lp(a), and 11% (977) showed elevated Lp(a) alone.¹

User satisfaction, measured among 5,300 individuals who returned kits between March 2025 and March 2026, produced a Net Promoter Score of 73.8 against an industry benchmark range of -10 to 19. Respondents cited the program's free cost, simple process, and access to actionable health information as key drivers of satisfaction.

Among adults who received an email invitation for 1-on-1 support after a high result, 15% engaged with a Care Navigator between November 2025 and March 2026.¹

Investigators on both posters called for strategies to close persistent testing gaps, including efforts to improve screening kit return rates and expand engagement with Family Heart Care Navigation.^1,2

References

1. Bardach SH, Brugger C, Hawke A, Wilemon K, MacDougall D, Paige H. Reducing gaps in cardiovascular risk factor awareness through free at-home LDL-C and lipoprotein(a) screening and support: insights from the first 30,950 tests ordered through the Family Heart Foundation Cholesterol Connect program. Presented at: 10th Annual Heart in Diabetes; June 19-21, 2026; Philadelphia, PA.

2. MacDougall DE, Baum S, Sperling L, Hartsuff B, Paige H, Wilemon KA. Prevalence and associated determinants of lipoprotein(a) testing in a contemporary cohort of US adults from the Family Heart Database. Presented at: 10th Annual Heart in Diabetes; June 19-21, 2026; Philadelphia, PA.

3. HCPLive. Updated ACC/AHA dyslipidemia guidelines incorporate LDL-C goals, Lp(a) focus, with Deepak Bhatt, MD, MPH. https://www.hcplive.com/view/updated-acc-aha-dyslipidemia-guidelines-incorporate-ldl-c-goals-lp-a-focus-with-deepak-bhatt-md-mph. Published March 25, 2026. Accessed June 20, 2026.