Affiliation:
1. Division of Cardiology Feinberg School of Medicine Northwestern University Chicago Illinois USA
2. Intermountain Healthcare Department of Population Health Sciences Spencer Fox Eccles School of Medicine University of Utah Salt Lake City Utah USA
3. Department of Neurology and National Clinician Scholars Program University of Michigan Ann Arbor Michigan USA
4. Lt. Col. Charles S. Kettles VA Medical Center Ann Arbor Michigan USA
5. Department of Emergency Medicine University of Michigan Ann Arbor Michigan USA
Abstract
AbstractLipoprotein(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]).