The short answer: if a parent, brother or sister had heart disease before 60, ask your GP for a full lipid profile and a QRISK3 score first, then ask about lipoprotein(a): HEART UK recommends measuring it once in exactly your situation, and it is not part of the standard NHS cholesterol test. ApoB, HbA1c and hs-CRP add context. If you only want Lp(a) and ApoB, a single test from Forth (£89) or Medichecks (Lp(a) £59) is cheaper than a full panel; if you have chest pain or breathlessness, see your GP, not a private lab.
A routine NHS lipid profile measures total cholesterol, HDL, non-HDL cholesterol and triglycerides, and usually calculates LDL. Your GP combines it with age, sex, blood pressure, smoking, diabetes, ethnicity and family history in QRISK3 to estimate your 10-year risk; NICE recommends offering statin treatment when that risk is 10% or more (NICE NG238).
That works well for most people. Where it can fall short in families with early heart disease is in the inherited markers it doesn't measure:
The HEART UK consensus statement on lipoprotein(a) (Cegla et al., Atherosclerosis, 2019) recommends measuring Lp(a) in adults with:
A personal or family history of premature atherosclerotic cardiovascular disease (before 60) · a first-degree relative with Lp(a) above 200 nmol/L · familial hypercholesterolaemia or another genetic dyslipidaemia · calcific aortic valve stenosis · a borderline increased (but under 15%) 10-year cardiovascular risk.
32 to 90 nmol/L: minor added risk · 90 to 200: moderate · 200 to 400: high · above 400: very high. Lp(a) "need only be measured once, unless a secondary cause is suspected or specific treatment is instituted".
European guidance goes further: the ESC/EAS 2019 dyslipidaemia guidelines recommend measuring Lp(a) at least once in every adult's lifetime (Mach et al., European Heart Journal, 2020).
Your GP. A lipid profile (no fasting needed for most people) and a QRISK3 score. QRISK3 already adds risk for a parent or sibling with angina or a heart attack before 60 (Hippisley-Cox et al., BMJ, 2017), so tell your GP about your family history; it changes the score. If your total cholesterol is above 7.5 mmol/L, NICE advises considering familial hypercholesterolaemia, especially with premature heart disease in the family (NICE CG71), and that route includes genetic testing and family screening on the NHS.
The NHS Health Check. Adults in England aged 40 to 74 without existing heart disease, diabetes or certain other conditions are invited every five years. It includes cholesterol and a cardiovascular risk score, but not Lp(a), ApoB or hs-CRP (NHS).
Where private testing helps. Lp(a) and ApoB are rarely requested in primary care unless a lipid clinic is involved. A one-off private Lp(a) gives you a number you will not need to repeat, and that you can take to your GP. If you need help phrasing the request, see what blood tests to ask your GP for.
Where it doesn't. If you already have heart disease, are under a lipid clinic, or are being assessed for FH, your NHS team will order what is needed. A private panel does not replace an ECG, a cardiology referral, or the care of someone with symptoms. Chest pain, breathlessness on exertion or palpitations need your GP (or 999 if severe).
Checked on each provider's own website on 15 October 2026. "Not listed" means the marker did not appear on the product page we checked.
| Provider and test | Price | Lp(a) | ApoB | hs-CRP | HbA1c | Collection |
|---|---|---|---|---|---|---|
| TrueVitals Ultimate (140 markers, + fasting insulin, HOMA-IR) | £349 + £19 clinic draw or £39 home visit | Yes | Yes | Yes | Yes | Venous only, clinic or home visit |
| Forth Advanced Cholesterol Home Test Kit | £89 | Yes | Yes | Not listed | Not listed | Finger-prick free; AutoDraw +£20; nurse +£59; clinic +£45 |
| Forth Heart Health Home Blood Test Kit | £76 | Not listed | Not listed | Yes | Yes | Finger-prick free; other options extra |
| Medichecks Lipoprotein (a) Blood Test | £59 | Yes | Separate Apolipoprotein Profile, £89 | Not listed | Not listed | Not stated on listing |
| Medichecks Optimal Health Blood Test | £249 | Yes | Yes | Yes | Yes | Venous: self-arranged, clinic +£35, nurse +£59 |
| Thriva Lp(a) Cardiovascular Risk Profile | £108 (nurse +£60) | Yes | Yes (apolipoproteins) | Not listed | Not listed | Autodraw device ("no finger pricking") |
| Thriva Advanced Longevity Blood Test | £172 | Not listed | Yes | Yes | Yes | Home kit; nurse +£60 |
| Lola Health Peak Insights 70 | £200 own phlebotomist; £235 clinic or home | Not listed | Yes | Yes | Yes | Venous |
| Randox Health Everyman Complete | £416 | Product page lists "Heart Health" as an area but not individual markers; ask Randox before booking | Clinic | |||
Prices checked October 2026. Sources: forthwithlife.co.uk (Advanced Cholesterol Home Test Kit, Heart Health Home Blood Test Kit); medichecks.com (Specialist Tests collection, Optimal Health Blood Test); thriva.co (Lp(a) Cardiovascular Risk Profile, Advanced Longevity Blood Test); lolahealth.com/products/peak-insights; randoxhealth.com Everyman Complete. Panels change; confirm before you buy. Best blood test UK, ranked.
You just want your Lp(a) number. It only needs measuring once. Medichecks' standalone Lp(a) test (£59) or Forth's Advanced Cholesterol kit (£89, with ApoB and a finger-prick option) are much cheaper than a 140-marker panel. See Forth alternative and Medichecks alternative.
You want to test at home. TrueVitals has no finger-prick kit: every sample is a venous draw at one of 103 partner clinics or a home visit, and you book it by phone after paying. Forth and Thriva are more convenient for a kit through the letterbox.
You're under NHS care for your heart or cholesterol. Your lipid clinic or GP will order what is needed. Keep them as the people who act on your results.
Where TrueVitals fits. If you want Lp(a) and ApoB read together with HbA1c, fasting insulin, hs-CRP, kidney, liver and thyroid markers, Ultimate measures them in one venous sample and a clinician reviews a written report of every result. We're a newer brand than the others listed here; see the sample report and our heart health page to judge for yourself.
Start with your GP: a full lipid profile (total cholesterol, HDL, non-HDL, triglycerides) and a QRISK3 assessment, which already counts a parent or sibling with angina or a heart attack before 60. The tests a GP usually won't add are lipoprotein(a), which HEART UK recommends measuring once in people with a personal or family history of premature cardiovascular disease (Cegla et al., Atherosclerosis, 2019), and ApoB. HbA1c and, privately, fasting insulin and hs-CRP add context.
HEART UK's 2019 Lp(a) consensus uses cardiovascular disease before the age of 60 in a family member. QRISK3, the calculator NHS GPs use, asks whether a first-degree relative (parent, brother or sister) had angina or a heart attack before 60 (Hippisley-Cox et al., BMJ, 2017).
Lp(a) levels are genetically determined, so they change little over adult life. HEART UK states Lp(a) "need only be measured once, unless a secondary cause is suspected or specific treatment is instituted" (Cegla et al., 2019). The European Society of Cardiology and European Atherosclerosis Society recommend measuring it at least once in every adult's lifetime (Mach et al., European Heart Journal, 2020).
Lp(a) is not part of the standard NHS lipid profile or the NHS Health Check. Some lipid clinics and GPs will request it, particularly if familial hypercholesterolaemia or premature heart disease in the family is being investigated, so it is worth asking. Privately, single Lp(a) tests start from £59 (Medichecks, checked October 2026).
No. Familial hypercholesterolaemia (FH) is a specific inherited condition causing very high LDL cholesterol from birth. NICE advises considering FH in adults with a total cholesterol above 7.5 mmol/L, especially with a family history of premature coronary heart disease (NICE CG71). FH is diagnosed and managed through your GP and specialist lipid services, including genetic testing, not by a private wellness test.
Take the result to your GP. HEART UK classes 90 to 200 nmol/L as moderate, 200 to 400 high and above 400 very high risk (Cegla et al., 2019). HEART UK's advice for raised Lp(a) is to lower your overall risk: LDL cholesterol, blood pressure, smoking, weight and diabetes, managed with your GP. HEART UK also suggests testing first-degree relatives of people with Lp(a) above 200 nmol/L.
The NHS Health Check, offered every five years to adults aged 40 to 74 in England without existing heart disease, diabetes or certain other conditions, includes a cholesterol test and a cardiovascular risk score. It does not include Lp(a), ApoB or hs-CRP. It is free and worth doing; see the NHS Health Check page.
Ultimate includes Lp(a), ApoB, hs-CRP, HbA1c and fasting insulin, with a clinician-reviewed report within 4 working days. 140 biomarkers (139 for women), £349 plus £19 clinic draw or £39 home visit.
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