Plasma Lipoprotein(a) Levels as Determinants of Arterial Stiffening in Hypertension.

Gabriele Brosolo,Luca Bulfone,Gianluca Colussi,Alessandro Cavarape,Cristiana Catena,Nicole Bertin,Antonio Vacca,Andrea Da Porto,Leonardo A. Sechi

doi:10.3390/biomedicines9111510

Abstract

Previous studies have shown that plasma lipoprotein(a) (Lp(a)) plays an important role in the development of hypertensive organ damage. The aim of the present study was to investigate the relationship of Lp(a) with markers of arterial stiffening in hypertension. In 138 essential hypertensive patients free of diabetes, renal failure and cardiovascular complications, we measured plasma lipids and assessed vascular stiffness through the use of pulse wave analysis and calculation of the brachial augmentation index (AIx), and measured the pulse wave velocity (PWV). Plasma Lp(a) levels were significantly and directly related to both AIx (r = 0.490; p < 0.001) and PWV (r = 0.212; p = 0.013). Multiple regression analysis showed that AIx was independently correlated with age, C-reactive protein, and plasma Lp(a) (beta 0.326; p < 0.001), while PWV was independently and directly correlated with age, and inversely with HDL, but not with plasma Lp(a). Logistic regression indicated that plasma Lp(a) could predict an AIx value above the median for the distribution (p = 0.026). Thus, in a highly selective group of patients with hypertension, plasma Lp(a) levels were significantly and directly related to markers of vascular stiffening. Because of the relevance of vascular stiffening to cardiovascular risk, the reduction of Lp(a) levels might be beneficial for cardiovascular protection in patients with hypertension.

Highlights

The propensity of hypertensive patients to develop vascular damage is related to the direct influence of blood pressure levels, additional factors, including circulating lipids, play a crucial role in the process of vascular deterioration
The augmentation index (AIx) was significantly greater in hypertensive patients who were treated with diuretics
In a large sample of middle-aged, nondiabetic, essential hypertensive patients free of cardiovascular complications and renal failure we found that plasma Lp(a) levels were correlated with the pulse wave velocity (PWV) and, independently of possible confounders, with the brachial AIx, suggesting a contribution of this lipoprotein to arterial stiffening in hypertension

Summary

Introduction

The propensity of hypertensive patients to develop vascular damage is related to the direct influence of blood pressure levels, additional factors, including circulating lipids, play a crucial role in the process of vascular deterioration. Lipoprotein(a) (Lp(a)) is a heterogeneous lipoprotein that incorporates a low-density lipoprotein (LDL) particle and the highly polymorphic apolipoprotein(a) (apo(a)) [2]. Serum Lp(a) levels vary over a broad range and the apo(a) gene is the major gene controlling these levels [3]. Previous studies conducted in large groups of patients with high blood pressure have demonstrated that serum Lp(a) levels predict the presence and severity of hypertensive vascular damage [5]. These effects of Lp(a), together with its interaction with the hemostatic and

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