Lp(a) in Hypertensive Patients as a Predictor of Cardiovascular Events

Objective: This study aims to analyze the relationship between Lp(a) levels and HT, determining whether this association implies an increased risk. In this way, the goal is to assess the utility of this relationship as an effective tool for cardiovascular risk stratification. Design and method: A retrospective study with a history of recent coronary events was conducted from June 2020 to September 2023. Data were obtained from the computerized medical records. Demographic data, history of HT diagnosis, BMI, current tobacco use, family history, sedentary behavior, pharmacological treatment with statins and antihypertensives were collected. Additionally, serum levels of total cholesterol (Col-T), LDL-chol, HDL-chol and Lp(a) were documented. The nature of the event (first occurrence or readmission) was also recorded. Statistics analysis of regression and variance (ANOVA) was performed. Results: A total of 105 patients were included. Age average was 59.7±13, 60% were obese, 39% were current smokers, 31% were diabetic and 66% had sedentary habits (mean ± SD). Chol-LDL values was 136.4±44 and Lp(a) 89±113 (mg/dL mean ± SD). Lp(a) showed a significant correlation with readmissions due to ischemic heart disease, sedentary behavior, and LDL-C levels. Additionally, its value is independent of the other variables. When the regression analysis of Lp(a) (Lowess) was performed, adjusting for age, it became evident that patients with arterial hypertension and cardiovascular events have much higher levels of Lp(a) compared to those without events. Figure 1 Conclusions: According to available studies, the guideline recommends a universal cutoff point of 100 nmol/L (approximately 50 mg/dL), which approximates the 80th percentile in Caucasian populations in the United States. However, the use of this cutoff point remains a topic of debate among many experts in the lipid community,. This study highlights that in a population of hypertensive patients with elevated Lp(a), early cardiovascular events are observed. The incorporation of this variable into the patients’ risk score could be a strategy for reducing cardiovascular events.