Abstract 10239: Association of Lipoprotein(a) and Hypertension in Primary Prevention of Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Introduction: The presence of both dyslipidemia and hypertension is associated with considerable cardiovascular disease (CVD) risk, yet few studies have explored the relationship between elevated lipoprotein(a) (Lp(a)) and hypertension. This study explored the longitudinal relationship of Lp(a) and hypertension to cardiovascular outcomes in a large multiethnic cohort free of baseline CVD. Methods: Individuals from the Multi-Ethnic Study of Atherosclerosis (MESA) (n- 6,674) were grouped as follows: Group 1: Lp(a) < 50 mg/dL and no hypertension; Group 2: Lp(a) ≥ 50 mg/dL and no hypertension; Group 3: Lp(a) < 50 mg/dL and hypertension; and Group 4: Lp(a) ≥ 50 mg/dL and hypertension. Kaplan Meier curves and multivariable Cox proportional hazard models were used to assess the relationship between Lp(a) and hypertension with time to CVD events. Results: The mean follow up time was 13.9 years and there were a total of 809 CVD events. A statistically significant interaction was found between LogLp(a) and hypertension status (p = 0.086). Compared to the reference group (Lp(a) < 50 mg/dL and no hypertension), those with Lp(a) ≥ 50 mg/dL and no hypertension (Group 2) had no increase in risk for CVD events (HR: 1.07; 95% CI: 0.78, 1.46) (Table). However, those with Lp(a) < 50 mg/dL and hypertension (Group 3) or Lp(a) ≥ 50 mg/dL and hypertension (Group 4) demonstrated a statistically significant increase in CVD risk compared to the reference group (HR: 1.66; 95% CI: 1.40, 1.98) and (HR: 2.04; 95% CI: 1.62, 2.59), respectively (Table). Among those with hypertension (Groups 3 and 4), Lp(a) was associated with a significant increase in CVD risk (HR: 1.23; 95% CI: 1.00, 1.51). Conclusion: The present study found a significant interaction between Lp(a) and hypertension. More research is needed to understand the mechanistic link between Lp(a), hypertension, and CVD.