Atherogenic dyslipidemia and pulse pressure in arterial hypertension: pathophysiological links

Objective To evaluate the association between lipid profile parameters, particularly low-density lipoprotein cholesterol, and pulse pressure in patients with arterial hypertension high and very high CV risk and to assess the clinical relevance of this relationship. Materials and methods The study included 120 patients with arterial hypertension and dyslipidemia at high or very high cardiovascular risk (SCORE2: 18.12 ± 7.83). The mean age was 52.5 ± 9.6 years; the mean duration of hypertension was 8.7 ± 6.6 years, mean LDL-C levels 144.2 ±31.7 mg/dl and mean pulse pressure was 67.6 ± 12.7 mmHg. Central blood pressure parameters, including central pulse pressure, were assessed in all patients using applanation tonometry with the SphygmoCor system and as part of the laboratory examination, lipid spectrum levels were determined, including LDL-C. Statistical analysis was performed using standard methods of descriptive and correlation statistics. Spearman’s rank correlation coefficient (rs) was applied. Statistical significance was set at p < 0.05. Results Spearman correlation analysis demonstrated a strong positive association between low-density lipoprotein cholesterol (LDL-C) levels and pulse pressure in patients with arterial hypertension (rs = 0.80, p < 0.001). Higher LDL-C concentrations were consistently associated with increased pulse pressure, indicating a close relationship between atherogenic lipid burden and arterial stiffness–related hemodynamic alterations. Conclusion The strong correlation between LDL-C and pulse pressure highlights the pivotal role of dyslipidemia in the pathophysiology of arterial hypertension. These findings support the concept that atherogenic lipid abnormalities contribute to increased arterial stiffness, leading to unfavorable hemodynamic profiles.