Elevated Lipoprotein(a) Levels Are Associated With Adverse Left Ventricular Geometric Remodeling in Non-Diabetic Patients With Essential Hypertension

BACKGROUND: Lipoprotein(a) [Lp(a)] is an established cardiovascular risk factor associated with inflammation, endothelial dysfunction, oxidative stress, and arterial stiffness. Although elevated Lp(a) levels have been linked to cardiovascular disease, their relationship with left ventricular (LV) geometric remodeling in hypertension remains insufficiently characterized. This study aimed to investigate the association between serum Lp(a) levels and LV geometry in non-diabetic patients with essential hypertension. METHODS: This cross-sectional observational study included 110 non-diabetic patients with essential hypertension. Patients were categorized into low Lp(a) (<50 mg/dL, n = 70) and elevated Lp(a) (≥50 mg/dL, n = 40) groups. Comprehensive transthoracic echocardiography was performed to evaluate LV mass index (LVMI), relative wall thickness, and LV geometric patterns. Correlation, multivariate linear regression, and multinomial logistic regression analyses were used to determine independent associations between Lp(a) levels and LV remodeling parameters. RESULTS: , p < 0.001). Concentric LV hypertrophy was substantially more prevalent in the elevated Lp(a) group (55.0% vs. 20.0%, p = 0.001), whereas normal LV geometry was more frequently observed in patients with lower Lp(a) concentrations. Serum Lp(a) levels demonstrated a moderate positive correlation with LVMI (r = 0.357, p < 0.001). In multivariate linear regression analysis, Lp(a) remained independently associated with LVMI after adjustment for major clinical confounders (standardized β = 0.363, p < 0.001). Multinomial logistic regression analysis demonstrated that elevated Lp(a) levels were independently associated with markedly greater odds of concentric LV hypertrophy. CONCLUSIONS: Elevated serum Lp(a) levels were independently associated with adverse LV geometric remodeling and concentric hypertrophy in non-diabetic patients with essential hypertension. Assessment of Lp(a) levels may provide additional value for cardiovascular risk stratification and identification of hypertensive patients at increased risk for hypertensive target organ damage.