Elevated Lp(a) is a common, genetically determined trait in Africa rather than a rare dyslipidemia, acting as a significant amplifier of cardiovascular risk, particularly in the presence of rising incident rates of hypertension and diabetes.
Studies in Ghana reported prevalence rates of elevated Lp(a) (>30 mg/dL) between 30–61% among apparently healthy individuals.
Mean Lp(a) levels across African cohorts ranged from 12.7 mg/dL to 54.5 mg/dL depending on the cohort and assay used.
Females exhibited higher Lp(a) levels than males across most African cohorts included in the review.
Elevated Lp(a) was clinically associated with hypertension, type 2 diabetes mellitus, ischemic stroke, myocardial infarction, and antiretroviral drug use in African populations.
A total of 17 studies met the inclusion criteria, representing populations from West, Central, Southern, and North Africa.
The review concluded that elevated Lp(a) is a common, genetically determined trait in Africa rather than a rare dyslipidemia.
The review identified a need for standardized, isoform-independent assays and population-specific risk thresholds for African populations.
This research systematically reviewed 17 studies examining levels of a blood particle called Lipoprotein(a), or Lp(a), in apparently healthy people living across Africa. Lp(a) is a genetically determined molecule in the blood that, when elevated, significantly increases the risk of heart attacks, strokes, and other cardiovascular diseases. The review found that elevated Lp(a) is surprisingly common in African populations — in Ghana alone, between 30% and 61% of apparently healthy individuals had levels considered clinically elevated (above 30 mg/dL). Women tended to have higher Lp(a) levels than men across most African populations studied. Elevated Lp(a) was also linked to serious conditions including high blood pressure, type 2 diabetes, ischemic stroke, heart attack, and use of antiretroviral drugs (medications used to treat HIV). This research suggests that high Lp(a) is not a rare or unusual finding in Africa — it appears to be a common genetic trait that may be amplifying cardiovascular risk across the continent, especially as rates of diabetes and hypertension continue to rise. Despite this, the condition remains largely unstudied and unrecognized in African healthcare settings. The review also highlighted that different studies used different measurement methods, making it difficult to directly compare results or establish clear cutoffs for what constitutes a dangerous level in African populations specifically. The practical implication of this research is that Africa may be facing a largely hidden cardiovascular risk factor affecting a substantial proportion of its population. The authors call for adoption of standardized testing methods and the development of Africa-specific guidelines for Lp(a) screening and risk management. Addressing this gap could be important for improving cardiovascular disease prevention and care across the continent, particularly as new therapies targeting Lp(a) are being developed globally.
Appiah L, Akumiah F, Idan J, Amponsah G, Gyabaah S, Baah B, et al.. (2026). The burden of Lipoprotein(a) [Lp(a)] in Africa: A systematic review.. PloS one. https://doi.org/10.1371/journal.pone.0356490