LPA and familial hypercholesterolemia: MESA used baseline Lp(a) and LDL-C results, excluded individuals on lipid-lowering therapy, and had only a small number of individuals with isolated elevated Lp(a) level (n=130 among the total population of 4585).7 In addition, the risk of Lp(a) level and very elevated LDL-C level appears to be additive, with higher risk when elevated Lp(a) level and familial hypercholesterolemia are both present.35