Mechanisms
In 227 hypertensive patients, elevated Lp(a) tracks specifically with worse nocturnal blood pressure and pulse pressure patterns (Sci Rep 2024)
Original title: Assessing the relationship between lipoprotein(a) levels and blood pressure among hypertensive patients beyond conventional measures. An observational study
This observational study analysed 24-hour ambulatory blood pressure monitoring data alongside demographic, clinical and laboratory variables in 227 hypertensive patients (median age 56 years, 56% women), comparing those with Lp(a) above versus below 125 nmol/L. A 10 mmHg increase in nocturnal systolic blood pressure was associated with more than a 20% higher risk of belonging to the elevated Lp(a) group, and the same increase in 24-hour, daytime, or night-time pulse pressure was associated with more than a 40% higher risk. Conversely, each 10% increase in nocturnal diastolic blood pressure dipping was associated with more than a 30% lower odds of elevated Lp(a). Patients with Lp(a) at or above 125 nmol/L also had higher 24-hour, daytime and night-time systolic blood pressure and pulse pressure load. Lp(a)'s relationship with hypertension extends beyond simple office blood pressure readings to specific ambulatory patterns, particularly nocturnal blood pressure and pulse pressure, both of which carry independent prognostic weight.
Original abstract
High lipoprotein(a) (Lp(a)) levels are associated with an increased risk of arterial hypertension (AHT) and atherosclerotic cardiovascular disease. However, little is known about the detailed profile of AHT based on Lp(a) levels. This observational study focused on elucidating the relationship between Lp(a) concentrations and specific indices obtained from 24-h ambulatory blood pressure (BP) monitoring in hypertensive patients over 18 years of age. We gathered and analyzed data on BP indices along with demographic, epidemiological, clinical, and laboratory variables from 227 hypertensive patients, median age 56 years, including 127 women (56%). After comparing hypertensive patients with Lp(a) levels above and below 125 nmol/L, we found that a 10 mmHg increase in nocturnal systolic BP and all pulse pressure indices (24-h, daytime, and night-time) was associated with an increased risk of high Lp(a) levels by more than 20% and 40%, respectively. Similarly, each 10% increase in the area under the function over time of nocturnal diastolic BP dipping was associated with more than a 30% decrease in the odds of belonging to the elevated Lp(a) levels category. Additionally, Lp(a) levels above 125 nmol/L were associated with higher 24-h, daytime, and night-time systolic BP and pulse pressure load. The relationship between Lp(a) and AHT appears to extend beyond conventional BP measurements, which may be relevant given the prognostic implications of nocturnal BP and pulse pressure indices.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.