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.

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The correlation of apolipoprotein B, apolipoprotein B/apolipoprotein A-I ratio and lipoprotein(a) with myocardial infarction

Open Medicine ◽

10.2478/s11536-008-0057-3 ◽

2008 ◽

Vol 3 (4) ◽

pp. 422-429

Author(s):

Lucia Agoston-Coldea ◽

Teodora Mocan ◽

Marc Gatfossé ◽

Dan Dumitrascu

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiovascular Risk ◽

Total Cholesterol ◽

Cardiovascular Risk Factors ◽

Apolipoprotein B ◽

Hdl Cholesterol ◽

Lipoprotein A

AbstractRecent evidence shows that apolipoprotein (apo) B, apoB/apoA-I ratio and lipoprotein(a) are better indicators of coronary risk than the conventional lipid profile. The aim of this study was to evaluate the correlation of apoA-I and B, and lipoprotein(a) with myocardial infarction (MI). We performed a cross-sectional study including 208 patients (100 men and 108 women), with and without previous MI evaluated by coronary angiography. The severity of coronary heart disease was scored on the basis of the number and extent of lesions in the coronary arteries. Lipid levels were measured by the enzymatic method and apolipoprotein levels were measured by the immunoturbidimetric method. The MI group had higher plasmatic levels of lipoprotein(a) (0.37±0.28 vs. 0.29±0.23 g/L, p<0.05), apoB (1.13±0.40 vs. 0.84±0.28 g/L, p<0.05) and of the apoB/apoA-I ratio (0.77±0.37 vs. 0.68±0.20, p<0.05) compared to controls. The area under the receiver operating characteristic (ROC) curves (AUC) suggested a good reliability in the diagnose of coronary heart disease for the apoB/apoA-I ratio (0.756, p<0.05), apoB (0.664, p<0.05), lipoprotein(a) (0.652, p<0.05) and total cholesterol/HDL-cholesterol (0.688, p<0.05). Multivariate analysis performed with adjustments for cardiovascular risk factors, showed that the levels of lipoprotein(a), apoB and apoB/apoA-I ratio are significant independent cardiovascular risk factors. Our results indicate that there is an important relationship among high plasma apoB concentration, lipoprotein(a) concentration, the apoB/apoA-I ratio, and MI. We showed that the apoB/apoA-I ratio has a stronger correlation with MI than the total cholesterol/HDL cholesterol ratio. We therefore suggest using apoB/apoA-I ratio and lipoprotein(a) in clinical practice as a markers of MI risk.

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Relation of lipoprotein(a) in 11- to 19-year-old adolescents to parental cardiovascular heart disease

Clinical Chemistry ◽

10.1093/clinchem/39.3.477 ◽

1993 ◽

Vol 39 (3) ◽

pp. 477-480 ◽

Cited By ~ 19

Author(s):

J C Vella ◽

E Jover

Keyword(s):

Heart Disease ◽

Ldl Cholesterol ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Young Population ◽

Serum Samples ◽

Apo B ◽

Lipoprotein A ◽

Cardiovascular Heart Disease

Abstract We studied several risk factors in relation to parental cardiovascular heart disease: total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein (apo) A-I, apo B, and lipoprotein(a) [Lp(a)] were determined in 322 serum samples (43 from subjects with and 279 without parental cardiovascular heart disease). The distribution of Lp(a) concentrations in our young population was similar to that of other white populations, i.e., markedly skewed, with higher frequencies at low values. As compared with children whose parents did not report cardiovascular heart disease, those with affected parents had a higher mean Lp(a) (0.23 vs 0.18 g/L; P < 0.05). Moreover, 42% of the children with parental cardiovascular heart disease, but only 19% of those with no parental cardiovascular heart disease, exhibited Lp(a) values > 0.30 g/L. These results suggest not only that Lp(a) is an important risk factor for cardiovascular heart disease, but also that Lp(a) is more strongly related to the risk of cardiovascular heart disease than are HDL- and LDL-cholesterol and apo A-I and B.

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Lipoprotein(a) Plasma Concentrations, Apolipoprotein (a) Polymorphism and Family History of Coronary Heart Disease in Patients with Essential Hypertension

European Journal of Cardiovascular Prevention & Rehabilitation ◽

10.1177/174182679600300210 ◽

1996 ◽

Vol 3 (2) ◽

pp. 191-197

Author(s):

C. Gazzaruso ◽

P. Buscaglia ◽

A. Garzaniti ◽

G. Bonetti ◽

S. Savino ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Essential Hypertension ◽

Family History ◽

Plasma Concentrations ◽

Lipoprotein A ◽

Apolipoprotein A ◽

History Of

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Cardiovascular Risk in a Spanish Population of Bipolar Disorder Patients: Results from the BIMET Study

European Psychiatry ◽

10.1016/s0924-9338(09)70834-x ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

J.M. Montes ◽

E. Vieta ◽

A. González-Pinto ◽

J. Rejas-Gutiérrez ◽

F. Mesa

Keyword(s):

Bipolar Disorder ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiovascular Risk ◽

Cardiovascular Mortality ◽

Hdl Cholesterol ◽

Cardiovascular Death ◽

Spanish Population ◽

Type I ◽

Schizophrenia Spectrum Disorders

Purpose:To estimate the 10-years coronary heart disease and cardiovascular mortality risks in a Spanish population of bipolar disorder (BD) patients.Methods:BIMET study is a 12-month, prospective, multicentre, naturalistic study which enrolled type I or II BD patients according to DSM-IV TR criteria. A fasting blood sample was drawn to evaluate glucose, total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Weight, height, waist circumference at the umbilicus and blood pressure were also recorded. Framinghan and SCORE functions were used to calculate the 10-year risk for coronary hearth disease or cardiovascular death respectively.Results:A total of 320 and 417 patients, mean age 46.3 (13.0) years, were included for the Framingham and SCORE calculations respectively. The overall mean (standard deviation) risk for coronary heart disease was 7.3% (7.8) according to Framingham algorithm, with 6.3% of patients classified as having a high risk of coronary disease (Framingham higher than 10%). The mean overall risk for cardiovascular mortality was 1.2% (2.4) according to SCORE algorithm, with 6.5% of patients falling within the high cardiovascular mortality risk segment; SCORE higher than 5%. No statistically significant differences were observed between type I and II patients.Conclusion:This study reflects a substantial risk for cardiovascular events or mortality in a Spanish cohort of bipolar disorder patients. Results were comparable to those seen in subject with schizophrenia spectrum disorders. Therefore, an effort for controlling all cardiovascular risk factors in bipolar disorder patients should be carried out by clinicians and health decision makers.

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