Arterial Hypertension and Dyslipidemia: Role of Lipoprotein(A)

Objective: Dyslipidemia is a common risk factor in patients with arterial hypertension (AH). Besides LDL cholesterol, also increased levels of Lipoprotein(a) (LpA) are associated with higher risk of cardiovascular events. Despite this, there are no established ways to treat LpA, because traditional hypolipidemic drugs have none or only modest effect on LpA levels; however, several promising drugs are in testing. Contrary to the current guidelines, due to absence of effective therapy, LpA levels aren’t routinely evaluated at clinical practice. Aim of our study was to measure LpA in outpatients with AH to see how many of them would be eligible for future treatment. Design and method: We included 55 outpatients who were examined at our department between October and December of 2023. Standard laboratory tests including LpA, basic history, anthropometric and clinical evaluation were carried out. LpA was measured using Randox kit and reported in mg/dl. LpA levels were expressed as median and interquartile range (IQR). Patients with normal LpA levels were defined as 50 mg/dl. Results: We examined 55 patients with AH (29 men, 26 women) aged 71,36±10,19 years. Median level of Lp(a) was 18 mg/dl IQR 8-46. Normal LpA levels were in 65,5% patients and elevated LpA levels in 23,6% patients. There were no significant differences of LpA between genders, nor we found any significant correlation between LpA and total, LDL and HDL cholesterol, glycemia, creatinine, ALT, TSH, BMI or NTproBNP. However, there was a significant correlation between LpA and triacylglycerols (r = 0,307; p=0,024). We did not find higher levels of LpA in patients with previous myocardial infarction, stroke, or peripheral artery disease. Conclusions: In our study we found 23,6% patients with AH had LpA > 50 mg/dl. Some of these patients might be eligible for targeted LpA treatment in future.