Role of lipoprotein(a) in the development of coronary heart disease in patients with essential hypertension

Lipoprotein(a) [Lp(a)] is an important and independent cardiovascular risk factor, but its role in the development of coronary heart disease (CHD) in hypertensives have had conflicting results. In order to study the possible role of Lp(a) in the development of coronary heart disease in hypertensive patients, we evaluated Lp(a) levels in 45 (younger than 50 years) CHD hypertensive patients, 45 patients with essential hypertension with?out CHD and 64 healthy controls. Lp(a) was measured by nephelometric assays in fresh serum samples. The levels of Lp(a) were significantly greater in CHD hypertensive patients (0.33 ?0.17 g/L) than in controls (0.18 ? 0.08 g/L) or patients with essential hypertension (0.20 ? 0.05 g/L). The levels of Lp(a) were increased more than 0.30 g/L in 46.6% of CHD hypertensive patiens, in 17.7% of hypertensive patiens and in 8.8% of controls. CHD hypertensive patients had also greater levels of total cholesterol, LDL-cholesterol and triglycerides than hypertensive patients and controls. HDL-cholesterol levels were significantly lower in CHD hypertensive patients. This study indicates that high Lp(a) levels can play a major role in the development of CHD in patients with essential hypertension. These findings suggest the great importance of identifying, among hypertensive patients, subjects with higher levels of Lp(a), who belong to a group with cardiovascular risk on the basis of their hypertension.