There is striking evidence that a high lipoprotein(a) [Lp(a)] concentration is a strong, independent, and causal cardiovascular risk factor. However, Lp(a) testing rates are very low (1 %-2 %) despite the fact that 1 in 5 individuals have elevated Lp(a) concentrations. The Brussels International Declaration on Lp(a) Testing and Management was co-created by the Lp(a) International Task Force and global leaders at the Lp(a) Global Summit, held in Brussels, Belgium, on March 24-25, 2025. The event, organized by FH Europe Foundation, brought together scientific experts, people with the lived experience of elevated Lp(a) and policy makers from the European Institutions and World Health Organization. The World Heart Federation, Global Heart Hub, and European Alliance for Cardiovascular Health and scientific organizations such as European Atherosclerosis Society, and International Atherosclerosis Society were formal partners. The Summit was hosted by a Member of the European Parliament, Romana Jerković, and held under the patronage of the Polish presidency of the Council of the European Union. The Declaration calls for 1) integration of Lp(a) testing and management into Global, European and National Cardiovascular Health Plans; 2) appropriate investment, policy and programmes in targeting Lp(a) testing and management based on a recent study demonstrating the substantial overall cost-saving to health systems across the globe; 3) political commitment to mandate systematic Lp(a) testing at least once during a person's lifetime, ideally at an early age, with full reimbursement; 4) incorporation of Lp(a) test results in the context of a person's cardiovascular risk assessment, with development of personalised cardiovascular health roadmaps as needed, without fear of dredit aiscrimination; 5) investment in public and healthcare professional education to increase awareness of Lp(a) and its impact on cardiovascular health.

3rd Department of Internal Medicine 1st Faculty of Medicine Charles University General University Hospital Prague Czech Republic

Center for Endocrinology Diabetes and Preventive Medicine Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany

Department of Cardiovascular Medicine Graduate School of Medical Sciences Kanazawa University Kanazawa Japan

Department of Cardiovascular Medicine Kyorin University Faculty of Medicine Mitaka Japan

Department of Clinical Biochemistry Copenhagen University Hospital Herlev and Gentofte Denmark; The Copenhagen General Population Study Copenhagen University Hospital Herlev and Gentofte Denmark; Institute of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Denmark

Department of Internal Medicine and Pediatrics Ghent University Hospital Ghent Belgium

Department of Laboratory Medicine and Pathology Mayo Clinic Rochester MN USA

Department of Public Health and Primary Care Imperial College London London UK

Department of Vascular Medicine Amsterdam Cardiovascular Sciences Amsterdam University Medical Center University of Amsterdam Amsterdam Netherlands

EFLM Brussels Belgium

European Regional and Local Health Authorities Brussels Belgium

FASTA University School of Medicine Pharmacology and Research Department Mar Del Plata Argentina

FH Europe Foundation Amsterdam Netherlands

FH Europe Foundation Amsterdam Netherlands; Stichting Health Clusternet Amsterdam Netherlands; Centre for Health and Technology University of South Eastern Norway Norway

Global Heart Hub Galway Ireland

Hospital Israelita Albert Einstein and University of Sao Paulo Brazil

Institute of Genetic Epidemiology Medical University of Innsbruck Innsbruck Austria; Lp International Task Force FH Europe Foundation Amsterdam Netherlands

Institute of Science Tokyo Depatment of Medical Genetics Tokyo Japan

International Atherosclerosis Society Washington DC USA

International Atherosclerosis Society Washington DC USA; Center for Lipid Metabolomics Brigham and Women's Hospital Harvard Medical School Boston MA USA

Lp Geneva Switzerland

Lp Group Centre for Medicine Use and Safety Faculty of Pharmacy and Pharmaceutical Sciences Monash University Melbourne Australia

Lp International Task Force FH Europe Foundation Amsterdam Netherlands

Lp International Task Force FH Europe Foundation Amsterdam Netherlands; Cardiovascular Center Osaka Medical and Pharmaceutical University Osaka Japan

Lp International Task Force FH Europe Foundation Amsterdam Netherlands; Center for Innovation in Medicine Bucharest Romania

Lp International Task Force FH Europe Foundation Amsterdam Netherlands; Department of Cardiovascular Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai China

Lp International Task Force FH Europe Foundation Amsterdam Netherlands; Department of Pediatrics Amsterdam University Medical Centers University of Amsterdam Amsterdam Netherlands

Lp International Task Force FH Europe Foundation Amsterdam Netherlands; FH Europe Foundation Amsterdam Netherlands

Lp International Task Force FH Europe Foundation Amsterdam Netherlands; Movement Health Foundation Switzerland

Lp International Task Force FH Europe Foundation Amsterdam Netherlands; Preventive and Genomic Cardiology McGill University Health Center Montréal Québec Canada

Monash University Victoria Heart Institute Melbourne Australia

Sections of Cardiology and Cardiovascular Research Department of Medicine Baylor College of Medicine and the Texas Heart Institute Houston TX USA

Stichting Health Clusternet Amsterdam Netherlands

Zagreb School of Medicine University of Zagreb University Hospital Center Zagreb Zagreb Croatia

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