CHANGES IN LIPID METABOLISM INDICATORS IN PATIENTS WITH ESSENTIAL HYPERTENSION II AND III STAGES

Objective: Determine the characteristics of changes in lipid metabolism indicators in patients with essential arterial hypertension (AH) II and III stages. Design and method: 381 patients with AH were examined, stage II AH was diagnosed in 231 (60.6%) patients, stage III – in 150 (39.4%). 259 (68.0%) patients had a combination of AH with coronary heart disease (CHD). The control group included 30 practically healthy donors of similar age and sex. All individuals were measured for total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL and LDL), triglycerides (TG), lipoprotein (a) (Lp(a)), apolipoprotein A-1 and B100 levels. Results: Proatherogenic shifts in the lipid spectrum were observed in patients with AH II stage: an increase in the levels of TC, LDL and a decrease in HDL, which was significantly different to control group (p<0.0001). An increase in the level of Lp(a) to 35.7 mg/dL was determined in patients with stage II AH, which significantly exceeded the control group indicators (p=0.0001). Analysis of lipid indicators in patients with AH II stage with concomitant CHD compared to patients without CHD did not reveal significant differences between the two groups, except for an increase in Lp(a) level by 24.4%: from 35.7 mg/dL in the group with AH without CHD to 44.4 mg/dL in the group with AH and CHD (p<0.05). A significant increase in the level of Lp(a) was found in patients with AH III stage compared to the level of Lp(a) in people with AH II stage. Thus, the level of Lp(a) in the group with AH III stage was equal to 47.11 mg/dL, which was 28.5% higher than the indicators in patients with AH II stage (p=0.002) and almost 2.6 times the value of the control group (p<0.0001). A reliable direct correlation was found between the level of Lp(a) and the AH stage (r=0.36, p=0.0001). Conclusions: The obtained data indicate the high prognostic significance of Lp(a) in patients with AH both in the development and formation of hypertension itself, as well as in terms of the development and progression of coronary heart disease in patients with AH.