Epidemiology
Lp(a) above 50 mg/dL raises incident hypertension risk in normotensive adults over 50, but not younger ones, in 5,307 patients (J Clin Hypertens 2024)
Original title: Lipoprotein(a) among normotensive patients and risk of incident hypertension
In 5,307 normotensive patients (median age 26 years) followed for a median 10 years using Cox proportional hazards models, baseline Lp(a) categorized as 15 to under 30, 30 to 50, and above 50 mg/dL showed no significant association with incident hypertension overall compared with below 15 mg/dL (hazard ratios of 0.91, 1.05, and 1.02, respectively). However, in the subgroup of adults over 50 at baseline, Lp(a) above 50 mg/dL was significantly associated with increased incident hypertension (hazard ratio 1.62, 95% CI 1.17-2.26). Given Lp(a)'s known disruptive effect on endothelial cells critical to blood pressure regulation, the findings suggest elevated Lp(a) may specifically contribute to new-onset hypertension in older, previously normotensive adults, an association not evident in the broader, younger cohort.
Original abstract
Lipoprotein(a) has been shown to be disruptive to local endothelial cells, whose integrity is critical to blood pressure (BP) regulation. Cross-sectional analysis has shown an association between lipoprotein(a) and prevalent hypertension, though it is unclear if lipoprotein(a) increases risk of incident hypertension. To assess this, the authors measured baseline lipoprotein(a) among 5307 normotensive patients (median age 26 years (interquartile range [IQR] 12-50) and used Cox proportional hazard models to generate hazard rations (HR) with 95% confidence intervals (CI; median follow-up 10-years). The authors categorized lipoprotein(a) as <15 mg/dL, 15-<30 mg/dL, 30-50 mg/dL, >50 mg/dL, and performed subgroup analysis of adults >50 years at baseline. Incident hypertension was defined as a measured BP ≥140/90 mm Hg or a new ICD-9/10 code. After adjustment, hypertension for patients with baseline lipoprotein(a) 15-<30 mg/dL, 30-50 mg/dL, and >50 mg/dL was 0.91 (0.72-1.16), 1.05 (0.79-1.38), and 1.02 (0.83-1.26; vs. <15 mg/dL). However, among adults >50 years, lipoprotein(a) >50 mg/dL was associated with increased incident hypertension (1.62 [1.17-2.26]).
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.