Abstract
Objective: To determine the peculiarities of lipid metabolism indicators’ changes in healthy individuals with a genetic predisposition to arterial hypertension (AH) and patients with essential arterial hypertension (EAH). Design and method: 231 patients with second stage of EAH (105 men and 126 women; average age was 52.3±1.2 years) were examined. The duration of EAH was 9.7±0.45 years. 121 of them had a concomitant stable coronary artery disease (CAD). The control group included 30 healthy people of similar age and gender. A comparison group consisted of 23 healthy individuals with a AH family history. Additionally to lipid spectrum, levels of lipoprotein (a) (Lp(a)), apolipoprotein B100 (apoB100) and apolipoprotein A-1 (apoA-1) were determined. Statistical calculations were performed using Statistica for Windows 10.0. Results: Patients with genetic predisposition to AH had similar to indicators in patients with II EAH stage proatherogenic changes in lipid fractions. Their Lp(a) levels increased to 29.9 (24.5; 32.1) mg/dl, which is 67.0% higher than the levels in the control group (p=0.0005). Levels of apolipoproteins (apoB100 and apoA1) in the serum of healthy persons with AH predisposition did not differ from the control group. Patients with stage II EAH showed an increase in proatherogenic fractions of lipoproteins, apoB100, Lp(a), and a decrease in high-density lipoprotein cholesterol (HDL-C) and apoA-1 compared to control (p<0.0001). Analysis of lipid indicators in patients with concomitant CAD compared to patients without CAD revealed no significant differences between these two groups, except of increasing in the Lp(a) level by 24.4% (p<0.05). A significant positive correlations were found between the Lp(a) level with both the sum of scores on the SCORE scale and the CAD presence (r=0.25 and r=0.35, p=0.002), respectively. Conclusions: The lipid metabolism disorders in people with determinism for AH begin even before an increase in blood pressure and are genetically determined. The addition of hypertension contributes to the further progression of lipid metabolism disorders. The obtained data indicate the high prognostic significance of Lp(a) in patients with EAH in the development and establishment of both hypertension itself and CAD and increasing of patients’ cardiovascular risk.
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