Mechanisms
Elevated Lp(a) is associated with concentric left ventricular hypertrophy in non-diabetic hypertension: a 110-patient echocardiographic study (Blood Press 2026)
Original title: Elevated lipoprotein(a) levels are associated with adverse left ventricular geometric remodeling in non-diabetic patients with essential hypertension
In a cross-sectional study of 110 non-diabetic patients with essential hypertension, the 40 with Lp(a) of 50 mg/dL or more had a higher left ventricular mass index than the 70 below (139.6 vs 117.6 g/m2) and more concentric hypertrophy (55.0 vs 20.0 percent); Lp(a) correlated with LV mass index (r = 0.357) and stayed independently associated after adjustment (beta 0.363), as did the odds of concentric hypertrophy. Small and single-centre, but a mechanistically plausible link between Lp(a) and hypertensive target-organ damage that fits the arterial-stiffness and inflammation literature.
Original abstract
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 are linked to cardiovascular disease, their association with left ventricular (LV) geometric remodelling in hypertension remains incompletely understood. This study aimed to evaluate the relationship 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 classified 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 assess LV mass index (LVMI), relative wall thickness, and LV geometric patterns. Correlation and multivariate regression analyses were used to determine the independent association between Lp(a) levels and LV remodelling parameters.
Results: Patients with elevated Lp(a) levels had significantly higher LVMI compared with those with lower levels (139.6±28.5 vs. 117.6±24.2 g/m², p<0.001). Concentric LV hypertrophy was more prevalent in the elevated Lp(a) group (55.0% vs. 20.0%, p=0.001). Serum Lp(a) levels were positively correlated with LVMI (r=0.357, p<0.001) and remained independently associated with LVMI after adjustment for clinical confounders (β=0.363, p<0.001). Elevated Lp(a) levels were also independently associated with increased odds of concentric LV hypertrophy.
Conclusions: Elevated serum Lp(a) levels are independently associated with adverse LV geometric remodelling and concentric hypertrophy in non-diabetic patients with essential hypertension. Measurement of Lp(a) may provide additional information for cardiovascular risk stratification and early identification of hypertensive patients at risk for target organ damage.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.