Epidemiology
Lp(a) does not correlate with blood pressure in essential hypertension despite comorbidity differences, cohort of 230 (High Blood Press Cardiovasc Prev 2026)
Original title: Lipoprotein(a) in Essential Hypertension: Associations with Blood Pressure and Hypertension-Mediated Organ Damage
Retrospective observational study of 230 outpatients with essential hypertension (42.6% women, mean age 66.3±11.5 years) at a Roman hypertension centre, stratified by Lp(a) (50 mg/dL cut-off). 32.2% had Lp(a) 50 mg/dL or more. The high-Lp(a) group had more men (74.3% vs 49.4%), dyslipidaemia (97.3% vs 75.0%) and comorbidities (55.4% vs 30.8%, all p<0.001) and more frequent lipid-lowering therapy and aspirin use, but paradoxically lower office systolic blood pressure (133.5 vs 138.8 mmHg, p=0.036). No significant Lp(a) differences were found across hypertension phenotypes by office or ambulatory blood pressure, and no correlation was found between Lp(a) and blood pressure regardless of treatment status. The authors conclude Lp(a) is not associated with blood pressure levels in essential hypertension, warranting further investigation of its role in this population.
Original abstract
Introduction: Although recommended for cardiovascular (CV) risk stratification in adults, the role of lipoprotein(a) [Lp(a)] in hypertension is not fully established.
Aim: To evaluate Lp(a) levels in adult outpatients with essential arterial hypertension.
Methods: A retrospective, observational study was conducted in outpatients of both sexes, aged ≥ 18 years, with treated or untreated essential hypertension, who were consecutively evaluated at the Hypertension Unit, Excellence Hypertension Center, Sant'Andrea Hospital, Rome, Italy. Participants underwent office and out-of-office blood pressure (BP) measurements, as well as assessment of hypertension-mediated organ damage (HMOD). BP measurements were performed, and hypertension phenotypes were classified according to 2023 European hypertension guidelines. Lp(a) levels were measured, and the study population was stratified according to a Lp(a) cut-off value of ≥50 mg/dl. Due to the non-uniform distribution, absolute Lp(a) values were logarithmically transformed.
Results: A total of 230 patients with available Lp(a) values were included (42.6% women, mean age 66.3 ± 11.5 years, BMI 27.1 ± 4.5 kg/m2, office BP 137.1 ± 18.1/83.7 ± 11.0 mmHg, 24-hour BP 129.8 ± 14.5/79.6 ± 9.8 mmHg, Lp(a) 51.4 ± 65.3 mg/dL), among whom 32.2% had Lp(a) ≥50 mg/dl. There were significantly higher proportions of men (74.3% vs. 49.4%; P < 0.001), dyslipidaemia (97.3% vs. 75.0%; P < 0.001) and comorbidities (55.4% vs. 30.8%; P < 0.001) in patients with high Lp(a) than in those with normal Lp(a), who also received more frequently lipid lowering therapies (P < 0.001) and aspirin (P = 0.003). However, lower office systolic BP values (133.5±18.8 vs. 138.8±17.6 mmHg: P = 0.036) were observed in patients with Lp(a) ≥50 mg/dL than in those with < 50 mg/dl. Also, no significant differences for Lp(a) levels were observed among various hypertension phenotypes, as defined by office (P = 0.156) or out-of-office BP values (P = 0.065). No significant correlations were found between Lp(a) and office or out-of-office BP levels, both in treated and untreated hypertensive outpatients.
Conclusions: In our population, Lp(a) levels were not associated with either office or out-of-office BP values, irrespective of antihypertensive treatment status. The role of Lp(a) in hypertension warrants further investigation.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.