HIGH BLOOD PRESSURE IS ASSOCIATED WITH AN INCREASED CARDIOVASCULAR RISK EXPRESSED BY ELEVATED LIPOPROTEIN A LEVELS

Objective: Arterial hypertension is a major modifiable cardiovascular risk factor, especially in coronary artery disease (CAD) patients. While lipoprotein (a) [Lp(a)] is known to contribute to recurrent cardiovascular events, its relationship with hypertension and CAD risk requires further investigation.;. The aim of the present study was to assess the link between Lp(a), hypertension and cardiovascular risk in patients with CAD. Design and method: This prospective observational study included 284 CAD patients admitted to the Emergency Clinical County Hospital Târgu Mures, Romania. The cohort was divided into two groups: group 1 (134 non-hypertensive) and group 2 (150 hypertensive). Data collected included demographics, medical history, lipid profile, inflammatory biomarkers, NTproBNP levels, Lp(a), and left ventricular ejection fraction (LVEF). Results: Group 1 patients had a higher prevalence of heart failure than group 2 (p=0.01), with no significant differences in gender or comorbidities like diabetes, peripheral artery disease, or stroke. Moreover, group 2 demonstrated significantly elevated Lp(a) levels (0.27±0.31 g/L versus 0.36±44.32; p=0.04) and lower high-density lipoprotein cholesterol (45.1±14.53 mg/ dl versus 41.05±11.844 mmHg; p = 0.01) compared to group 1. Additionally, non-hypertensive patients exhibited a lower LVEF than those hypertensive patients (40.63± 8.53 vs 43.32 ±6.03, p=0.005). Although hypertensive patients exhibited a slightly better LVEF compared to non-hypertensive patients, their NTproBNP levels were higher. A more pronounced inflammatory process was also observed in group 2 too; however, no statistically significant correlations were identified (all p>0.005). Conclusions: Hypertension is associated with a worse outcome and a higher cardiovascular risk as reflected by a worse lipid profile and elevated Lp(a) serum level. These findings highlight the role of Lp(a) in hypertensive patients as a key marker for a heightened risk of cardiovascular events. Therefore, measuring Lp(a) is essential for more accurate cardiovascular risk stratification in both primary and secondary prevention.