According to a new report released in February by the Heart and Stroke Foundation called By the Numbers: The State of Risk Factors for Heart Disease and Stroke in Canada, only half of Canadians know their own risk for cardiovascular disease, and nine in 10 of us have at least one risk factor for heart conditions.

One of those risk factors is your lipoprotein(a) – a particle in the blood and a sticky type of LDL “bad” cholesterol that puts you at a higher risk of heart disease and stroke. Our lipoprotein(a) or Lp(a) levels are almost entirely based on our genes. By about age 5, Lp(a) levels are already determined and stay that way throughout our lives. And while our Lp(a) contributes to LDL cholesterol, it’s not the only culprit – in fact, high LDL levels are mostly influenced by controllable risk factors such as smoking, lack of exercise, being overweight and a diet high in saturated and trans fats.

High Lp(a) affects about one in five Canadians, and it causes plaque buildup, which narrows our arteries and reduces blood flow. This buildup can lead to clotting and aortic valve narrowing, as well as atherosclerotic cardiovascular disease, which includes heart attacks, strokes and heart failure.

“It’s recommended that everyone take the test once in their lifetime. If you haven’t had it checked, ask your family doctor. If your Lp(a) level is high, we sometimes put people on cholesterol medication, but we also address other risk factors,” says Dr. Beth Abramson, a cardiologist and the Paul Albrechtsen professor in cardiac prevention and women’s health in the division of cardiology at St. Michael’s Hospital and the University of Toronto. (Specific medications just for high Lp(a) are currently being researched in clinical trials.)

Ask for the test at midlife or sooner if you’ve had a heart attack or stroke, you have been diagnosed with high cholesterol or if you have a family member who’s had heart disease before the age of 55 in men or 65 in women. It should be checked regardless of whether you have or have previously had issues with your cholesterol level. If your Lp(a) is elevated (that is, if it’s 50mg/dL or 120 nmol/L or higher), your risk of heart attack, stroke, peripheral artery disease, aortic stenosis and other heart conditions is increased – your healthcare provider will suggest medication and can recommend lifestyle changes that lower your LDL cholesterol.

You can’t lower your Lp(a), but clinical trials have shown that patients with higher levels who work to lower their LDL cholesterol have a better chance of lowering their risk of cardiovascular issues.

That’s good news, since you’d be hard-pressed to find someone who couldn’t rattle off a list of the basics that keep our hearts in good working order. “Heart disease is preventable and there are little steps we can take in our everyday routines to reduce our risk of heart attack and stroke,” she says. Healthy heart habits that can help do the trick include quitting smoking; exercising for at least 150 minutes a week (only half of Canadians are currently meeting this guideline); getting quality sleep; maintaining a nutrient-filled diet (opt for lots of fresh or frozen fruits and veggies, and choose foods that have lots of healthy fats like fish, nuts and olive oil); and learning to better deal with stress.

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“Being screened for risk of heart disease is important, and you should be routinely asking your healthcare provider about your blood pressure and cholesterol profile,” says Dr. Abramson. Getting your Lp(a) tested is super easy – your levels are found in routine blood work, but you need to ask your healthcare provider to test lipoprotein(a) specifically. It’s covered by many (but not all) provincial health insurance programs.