Testing
Lipoprotein(a) should be measured once in a lifetime as part of standard non-fasting lipid testing, German national guidance argues (Dtsch Arztebl Int 2023)
Original title: Lipid Profile and Lipoprotein(a) Testing
This review by Parhofer and Laufs outlines the role of lipid profile testing, including a single lifetime measurement of Lp(a), in cardiovascular risk assessment and treatment monitoring in Germany. Total cholesterol, triglycerides, HDL and LDL cholesterol, and non-HDL cholesterol can all be measured in the non-fasting state except in specific situations such as hypertriglyceridaemia, and the HDL quotient is considered an obsolete measure. Since a high Lp(a) concentration cannot currently be lowered with oral medications, the authors recommend that patients with elevated Lp(a) instead focus on lowering LDL cholesterol and minimising other cardiovascular risk factors. The main treatment goal remains achieving an LDL cholesterol target appropriate to the patient overall cardiovascular risk.
Original abstract
Background: The treatment of dyslipidemias plays a major role in the primary and secondary prevention of cardiovascular disease. Proper evaluation of the patient's lipid status is very important for risk assessment and as a guide to treatment.
Methods: This review is based on publications retrieved by a selective search of the literature, including current guidelines.
Results: Measurement of the plasma concentration of cholesterol, triglycerides, HDL- and LDL-cholesterol, calculation of the non-HDL cholesterol concentration, and-on a single occasion-determination of the lipoprotein (a) concentration enable the clinician to quantify the lipid-associated health risk and monitor the effects of treatment. These blood tests can be performed in a non-fasting state except in special situations (particularly, hypertriglyceridemia). The HDL quotient is an obsolete measure. The main goal of treatment is to achieve an LDL-cholesterol level adequate to the patient's cardiovascular risk through lifestyle modification and, if necessary, medication. A high lipoprotein (a) concentration cannot be lowered with orally administered drugs; above all, patients should lower their LDL-cholesterol levels while minimizing all other risk factors.
Conclusion: Measurement of the concentration of cholesterol, triglycerides, and HDL- and LDL-cholesterol and calculation of the non-HDL-C suffice as a guide to lipid-lowering treatment. The primary therapeutic goal is to lower LDL cholesterol.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.