Across the world, nearly one in five people carries an inherited cardiovascular risk factor they will likely never know about — not because the knowledge is unavailable, but because the systems meant to protect them have not yet made room for it. Lipoprotein(a), or Lp(a), is written into a person's genetic code before childhood and cannot be altered by diet or discipline, yet fewer than one in fourteen people in Asia Pacific and the Middle East have ever been tested. On the eve of World Heart Day 2025, global health experts gathered to name this silence for what it is: not a failure of individ
1 in 5 People Face Hidden Genetic Heart Disease Risk, Experts Warn of Lp(a) Testing Gap
Cardiovascular disease kills nearly 18 million people annually worldwide, with elevated Lp(a) as a significant unrecognized risk factor contributing to heart attacks and strokes.
Every test taken could mean a life saved
Mark
So one in five people have this elevated Lp(a), but almost nobody knows about it or gets tested. Why has it stayed so hidden for so long?
Mimi
It's partly because Lp(a) was only really understood as an independent risk factor relatively recently in medical science. For decades, doctors focused on LDL cholesterol and other modifiable risk factors. Lp(a) is genetic and unchangeable, so it didn't fit neatly into the lifestyle-modification framework that dominated heart health messaging.
Luke
But that's a gap between what the science knows and what the public knows. The webinar was organized by Novartis, which has a commercial interest in Lp(a) testing and treatment. How much of this push is driven by genuine public health need versus market opportunity?
Mimi
That's a fair question. The survey data is real—66 percent do skip routine heart checks, and only 7 percent have been tested for Lp(a) in that region. But you're right that Novartis has skin in the game. The call for policy integration and testing expansion would directly benefit their business.
Mark
The survey showed 58 percent expressed interest in testing when informed. That's a huge number. Does that suggest people actually want this information?
Luke
It suggests they want it when presented with information about it in a survey context. Real-world uptake is different. And we should note: the survey was commissioned by Novartis, so there's a framing question there too. How were people asked? What context were they given?
Mimi
Those are valid methodological concerns. The survey was nationally representative by age and gender across six markets, which is solid. But you're right that we don't know the exact wording or how the information was presented to respondents.
Mark
If Lp(a) is 90 percent genetically determined and set by age five, who should be tested? Everyone? Only people with family history?
Mimi
That's still being debated in the medical community. Some experts argue for universal screening, especially in high-risk populations. Others say targeted screening based on family history or existing cardiovascular disease is more practical. The webinar didn't settle that question.
Luke
And that matters for policy. If you're going to embed this into national guidelines, you need to know who gets tested, when, and what you do with the results. The webinar called for that integration but didn't detail what it should look like.
Mark
What about treatment? If someone finds out they have elevated Lp(a), what can they actually do about it?
Mimi
That's the hard part. Lifestyle changes don't work. There are some emerging therapies, but they're not widely available yet. So right now, the main benefit of testing is knowing your risk and being more aggressive about managing other modifiable factors like blood pressure and LDL cholesterol.
Luke
So you're asking people to get tested for something you can't really treat yet. That's a tough sell from a patient perspective, even if the risk is real.
Mimi
True. But knowing you have elevated Lp(a) does change how aggressively you pursue other interventions. It's not nothing, but it's also not a cure.
Le Pouls
- Cardiovascular disease claims 18 million lives each year, and a genetic culprit — Lp(a) — silently elevates that risk for roughly 1.6 billion people who remain almost entirely unaware of their condition.
- A 2025 survey of 1,800 adults across six Asia Pacific and Middle Eastern nations found that two-thirds skip routine heart checks and nearly half do not even know genetics can shape their heart disease risk.
- The condition is 90% determined by DNA, fixed by age five, and impervious to lifestyle changes — making it uniquely dangerous in a health culture that still leans heavily on diet and exercise as universal shields.
- When survey respondents were actually informed about Lp(a) and genetic testing, 58% said they wanted to be tested — revealing that the crisis is one of awareness, not apathy.
- On September 24, 2025, Global Heart Hub and Novartis convened international experts, patient advocates, and policymakers to demand that Lp(a) testing be embedded into national cardiovascular guidelines before more preventable deaths accumulate.
Across the world, nearly one in five people carries an inherited cardiovascular risk factor they will likely never know about — not because the knowledge is unavailable, but because the systems meant to protect them have not yet made room for it. Lipoprotein(a), or Lp(a), is written into a person's genetic code before childhood and cannot be altered by diet or discipline, yet fewer than one in fourteen people in Asia Pacific and the Middle East have ever been tested. On the eve of World Heart Day 2025, global health experts gathered to name this silence for what it is: not a failure of individual will, but a failure of collective imagination in medicine and policy.
Every year, cardiovascular disease kills nearly 18 million people — more than cancer — yet one of its most significant genetic drivers remains almost entirely invisible. Lipoprotein(a), or Lp(a), affects roughly one in five people worldwide. It is 90 percent genetically determined, stable from early childhood, and unresponsive to diet or exercise. Almost no one is tested for it.
A March 2025 survey of 1,800 adults across Australia, India, South Korea, Taiwan, Saudi Arabia, and the UAE laid bare the scale of the gap. Two-thirds of respondents skipped routine heart checks. Nearly half were unaware that genetics played any role in heart disease. Only 22 percent had heard of an Lp(a) test, and just 7 percent had taken one. Yet when informed about the condition and testing options, 58 percent expressed genuine interest — a finding that reframes the problem as ignorance, not indifference.
Ahead of World Heart Day, Global Heart Hub and Novartis convened an international webinar titled "Introducing the Little (a) with Big Consequences." Experts from patient advocacy, medical science, and health policy assembled to make the case for urgent action. Neil Johnson of Global Heart Hub argued that Lp(a) — the genetic risk factor most people have never heard of — is not even part of the public conversation on heart health, and that the media bears responsibility for changing that.
The science explains the urgency. Lp(a) is structurally similar to LDL cholesterol but carries an additional protein that makes it unusually adhesive, causing it to accumulate in artery walls, narrow blood vessels, and increase the likelihood of clots that can trigger heart attacks and strokes. No lifestyle intervention can meaningfully lower it.
The webinar brought together voices including Ram Khandelwal, who survived a heart attack at 33 and founded India's first heart patient support group, and Prof. Gerald Watts, who outlined the genetic mechanisms at work. Policy advisor Nicola Bedlington urged governments to embed Lp(a) testing into national cardiovascular guidelines, while Prof. Zanfina Ademi presented evidence that such testing is cost-effective for health systems. Clinicians from Korea, India, Australia, and the Middle East described the real-world challenges of diagnosing and managing the condition in their regions.
The collective call was clear: policymakers must integrate Lp(a) testing into national health strategies, health systems must make it accessible, clinicians must be equipped to act on results, and the public must be told this test exists. As Novartis's Judith Love put it, every test taken is a potential life saved — the task now is moving from awareness into action.
Every year, cardiovascular disease kills nearly 18 million people worldwide—more deaths than cancer causes. Yet one of the most significant genetic risk factors for heart attack and stroke remains almost entirely invisible to the people it threatens. Elevated lipoprotein(a), known as Lp(a), is an inherited condition that affects roughly one in five people globally. It operates independently of diet and exercise, determined almost entirely by genetics and locked in place by age five. And almost nobody gets tested for it.
A survey conducted across the Asia Pacific and Middle East region in March 2025 captured the scale of the blindness. Among 1,800 adults surveyed across Australia, India, South Korea, Taiwan, Saudi Arabia, and the United Arab Emirates, two-thirds reported skipping routine heart checks altogether. Nearly half did not recognize that genetics played any role in heart disease at all. When asked specifically about Lp(a), only 22 percent had even heard of a test for it. Just 7 percent had actually taken one. Yet when researchers presented the information about genetic risk and testing options, 58 percent of those same respondents expressed genuine interest in being tested—a clear signal that the gap was not indifference but ignorance.
On September 24, 2025, ahead of World Heart Day, Global Heart Hub and Novartis brought together international experts to confront this gap. The webinar, titled "Introducing the Little (a) with Big Consequences," assembled voices from patient advocacy, medical science, and health policy to make the case for action. Neil Johnson, Executive Director of Global Heart Hub, framed the problem plainly: cardiovascular disease remains the world's leading cause of death, yet the genetic risk factor most people have never heard of is not even part of the conversation. The media, he argued, had a vital role to play in changing that.
The science behind Lp(a) explains why the stakes are so high. Lp(a) is a lipoprotein particle structurally similar to LDL cholesterol, but with an added protein component that makes it unusually sticky. This stickiness causes it to accumulate in artery walls, contributing to plaque buildup. Over time, this narrows and hardens arteries, restricting blood flow and oxygen to vital organs. Elevated Lp(a) also increases the risk of blood clots forming inside vessels, which can suddenly block blood flow entirely—triggering heart attacks, strokes, or peripheral artery disease. Because Lp(a) levels are approximately 90 percent genetically determined and remain stable throughout life, no amount of exercise or dietary change can meaningfully lower them.
The webinar included testimony from Ram Khandelwal, who survived a heart attack at age 33 and went on to found India's first heart patient support group, the Heart Health India Foundation. His experience drove him to raise awareness about elevated Lp(a) among his members. Prof. Gerald Watts from the University of Western Australia explained the genetic mechanisms at work. Nicola Bedlington, Senior Policy Advisor for the Lp(a) International Task Force at FH Europe Foundation, urged policymakers to embed Lp(a) testing into national cardiovascular disease guidelines to close critical care gaps. Prof. Zanfina Ademi from Monash University presented evidence on the cost-effectiveness of testing, demonstrating its economic benefit to health systems. Experts from Korea, India, Australia, and the Middle East—including Prof. Youngwoo Jang and Dr. A. Sreenivas Kumar from Apollo Hospitals India—discussed the real-world challenges of diagnosing and managing the condition across their regions.
The unified message that emerged was a call to action at multiple levels. Policymakers need to integrate Lp(a) testing into national health guidelines and cardiovascular strategies. Health systems need to make testing accessible and affordable. Clinicians need to understand the condition and know how to interpret results. And the public needs to know that this test exists and that it could identify a risk factor that, once known, can be managed and monitored. Judith Love, President of Asia Pacific, Middle East & Africa at Novartis, captured the stakes in her closing remarks: every test taken could mean a life saved, ensuring no heart is lost too soon. The challenge now is moving from awareness to action—embedding this invisible threat into the visible machinery of global heart health.
Citations marquantes
Cardiovascular disease remains the world's leading cause of death, yet elevated Lp(a), a highly prevalent risk factor, is not even on most people's radar. That has to change.— Neil Johnson, Executive Director of Global Heart Hub
Every test taken could mean a life is saved, ensuring no heart is lost too soon. We must act now so that patients around the world are no longer left in the dark about this 'little (a) with big consequences.'— Judith Love, President, Asia Pacific, Middle East & Africa at Novartis
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