TY - JOUR
T1 - Prevalence and Correlates of Lipoprotein(a) Testing in a Diverse Cohort of U.S. Adults
AU - Razavi, Alexander C.
AU - Richardson, La Tonia C.
AU - Coronado, Fátima
AU - Vesper, Hubert W.
AU - Lyle, Alicia
AU - Bhatia, Harpreet S.
AU - Tsimikas, Sotirios
AU - Quyyumi, Arshed A.
AU - Vaccarino, Viola
AU - Eapen, Danny J.
AU - Isiadinso, Ijeoma
AU - Mehta, Anurag
AU - Yadalam, Adithya K.
AU - Osei, Jeffery
AU - Jacobson, Terry A.
AU - Yao, Zhiqi
AU - Dzaye, Omar
AU - Martin, Seth S.
AU - Nasir, Khurram
AU - Shapiro, Michael D.
AU - Blaha, Michael J.
AU - Whelton, Seamus P.
AU - Blumenthal, Roger S.
AU - Sperling, Laurence S.
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/6
Y1 - 2025/6
N2 - Background: Once-per-lifetime lipoprotein(a) [Lp(a)] testing is recommended by multiple professional societies during cardiovascular disease risk assessment. Objective: The purpose of this study was to assess the prevalence and identify correlates of Lp(a) testing in a real-world, diverse sample. Methods: Participants were ≥18 years of age from the All of Us Research Study who shared electronic medical record information through 2022 (N = 266,612). Completion of Lp(a) testing was defined by the following: presence of Lp(a) values, Systematized Nomenclature of Medicine Clinical Terms or Logical Observation Identifiers Names and Codes electronic health record listings for Lp(a) testing, or an Internal Classification of Diseases-10 code for elevated Lp(a). Multivariable logistic regression assessed the association of demographic, socioeconomic, and clinical variables with Lp(a) testing. Results: The mean age was 52 years, 61% were women, and 53% were non-Hispanic White. A total of 2,172 (0.8%) underwent Lp(a) testing, 86% of whom had clinical cardiovascular disease. Compared to non-Hispanic White individuals, non-Hispanic Black individuals (OR: 0.68, 95% CI: 0.58-0.81) had 32% lower odds of Lp(a) testing. Less than high school education (OR: 0.34, 95% CI: 0.25-0.44), unemployment (OR: 0.76, 95% CI: 0.68-0.85), and disability (OR: 0.77, 95% CI: 0.65-0.91) were associated with a 23% to 66% lower odds of Lp(a) testing. Among clinical factors, non-Lp(a) lipid abnormality (OR: 5.64, 95% CI: 4.72-6.79) and prevalent cardiovascular disease (OR: 3.21, 95% CI: 2.76-3.74) were strongly associated with Lp(a) testing. Conclusions: The prevalence of Lp(a) testing among US adults is exceedingly low, especially for non-Hispanic Black individuals and those with socioeconomic risk. These results underline the importance of emphasizing health equity in Lp(a) testing expansion.
AB - Background: Once-per-lifetime lipoprotein(a) [Lp(a)] testing is recommended by multiple professional societies during cardiovascular disease risk assessment. Objective: The purpose of this study was to assess the prevalence and identify correlates of Lp(a) testing in a real-world, diverse sample. Methods: Participants were ≥18 years of age from the All of Us Research Study who shared electronic medical record information through 2022 (N = 266,612). Completion of Lp(a) testing was defined by the following: presence of Lp(a) values, Systematized Nomenclature of Medicine Clinical Terms or Logical Observation Identifiers Names and Codes electronic health record listings for Lp(a) testing, or an Internal Classification of Diseases-10 code for elevated Lp(a). Multivariable logistic regression assessed the association of demographic, socioeconomic, and clinical variables with Lp(a) testing. Results: The mean age was 52 years, 61% were women, and 53% were non-Hispanic White. A total of 2,172 (0.8%) underwent Lp(a) testing, 86% of whom had clinical cardiovascular disease. Compared to non-Hispanic White individuals, non-Hispanic Black individuals (OR: 0.68, 95% CI: 0.58-0.81) had 32% lower odds of Lp(a) testing. Less than high school education (OR: 0.34, 95% CI: 0.25-0.44), unemployment (OR: 0.76, 95% CI: 0.68-0.85), and disability (OR: 0.77, 95% CI: 0.65-0.91) were associated with a 23% to 66% lower odds of Lp(a) testing. Among clinical factors, non-Lp(a) lipid abnormality (OR: 5.64, 95% CI: 4.72-6.79) and prevalent cardiovascular disease (OR: 3.21, 95% CI: 2.76-3.74) were strongly associated with Lp(a) testing. Conclusions: The prevalence of Lp(a) testing among US adults is exceedingly low, especially for non-Hispanic Black individuals and those with socioeconomic risk. These results underline the importance of emphasizing health equity in Lp(a) testing expansion.
KW - cardiovascular disease
KW - lipoprotein(a)
KW - preventive cardiology
KW - risk assessment
KW - risk factor
KW - testing
UR - https://www.scopus.com/pages/publications/105006536065
UR - https://www.scopus.com/inward/citedby.url?scp=105006536065&partnerID=8YFLogxK
U2 - 10.1016/j.jacadv.2025.101826
DO - 10.1016/j.jacadv.2025.101826
M3 - Article
AN - SCOPUS:105006536065
SN - 2772-963X
VL - 4
JO - JACC: Advances
JF - JACC: Advances
IS - 6P1
M1 - 101826
ER -