 |
|
Association of Serum Lipoprotein(a) Levels and Apolipoprotein(a) Size Polymorphism With Target-Organ Damage in Arterial Hypertension
Leonardo A. Sechi, MD;
Florian Kronenberg, MD;
Stefano De Carli, MD;
Edmondo Falleti, PhD;
Laura Zingaro, MD;
Cristiana Catena, MD;
Gerd Utermann, MD;
Ettore Bartoli, MD
JAMA. 1997;277(21):1689-1695.
Abstract
| |
Objective.
—To investigate the association between lipoprotein(a) [Lp(a)] and other plasma lipids and apolipoproteins and target-organ damage (TOD) in patients with arterial hypertension.
Design.
—Cross-sectional study of a case series.
Setting.
—University medical center.
Participants.
—Lipoprotein(a) and apolipoproteins were analyzed in 277 untreated patients with mild to moderate essential hypertension and in 102 healthy controls. Apolipoprotein(a) [apo(a)] phenotypes were additionally analyzed in an independent sample set of 106 hypertensive and 105 control subjects.
Main Outcome Measures.
—Staging of TOD obtained according to World Health Organization guidelines by clinical evaluation, and laboratory tests including measurments of creatinine clearance, proteinuria, ophthalmoscopy, electrocardiography, echocardiography, and ultrasound examination of major arteries; levels of lipids, apolipoproteins, Lp(a), fibrinogen, and apo(a) phenotypes.
Results.
—Blood pressure, duration of hypertension, and levels of total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, Lp(a), and fibrinogen were significantly related to the presence and severity of TOD in univariate analysis. Stepwise multivariate analysis showed Lp(a) levels (P<.001) to be the best discriminator of the presence of TOD, followed by systolic blood pressure (P<.001), duration of hypertension (P=.01), and low-density lipoprotein cholesterol (P=.04). The Lp(a) levels were related to TOD independent of the level of blood pressure. We confirmed this association between Lp(a) concentrations and severity of TOD in a second independent sample set and observed a significantly higher frequency of low-molecular-weight apo(a) isoforms with increasing severity of TOD (P=.02).
Conclusions.
—Lipoprotein(a) and apo(a) phenotype are sensitive indicators of the severity of TOD in patients with essential hypertension, and their evaluation might permit identification of hypertensive subjects liable to the development of organ damage. The higher frequency of low-molecular-weight apo(a) isoforms in patients with TOD demonstrates a genetically determined risk for the development of TOD in hypertensive patients.
Author Affiliations
From the Hypertension Unit, Department of Internal Medicine (Drs Sechi, De Carli, Zingaro, Catena, and Bartoli), and Department of Laboratory Medicine (Dr Falleti), University of Udine, Udine, Italy; and Institute of Medical Biology and Human Genetics, University of Innsbruck, Innsbruck, Austria (Drs Kronenberg and Utermann).
Footnotes
Presented in part at the 11th Meeting of the American Society of Hypertension, New York, NY, May 17, 1996.
Reprints: Leonardo A. Sechi, MD, Hypertension Unit, Department of Internal Medicine, University of Udine School of Medicine, Ospedale Civile, Padiglione Medicine, 33100 Udine, Italy (e-mail: Sechiuniud.it).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Progressive kidney disease in three sisters with elevated lipoprotein(a)
Staples et al.
Nephrol Dial Transplant 2008;23:1756-1759.
FULL TEXT
Cardiovascular Outcomes in Patients With Primary Aldosteronism After Treatment
Catena et al.
Arch Intern Med 2008;168:80-85.
ABSTRACT
| FULL TEXT
Insulin Resistance and Hyperinsulinemia Are Related to Plasma Aldosterone Levels in Hypertensive Patients
Colussi et al.
Diabetes Care 2007;30:2349-2354.
ABSTRACT
| FULL TEXT
Relationships of Plasma Renin Levels with Renal Function in Patients with Primary Aldosteronism
Catena et al.
CJASN 2007;2:722-731.
ABSTRACT
| FULL TEXT
Insulin Sensitivity in Patients with Primary Aldosteronism: A Follow-Up Study
Catena et al.
J. Clin. Endocrinol. Metab. 2006;91:3457-3463.
ABSTRACT
| FULL TEXT
Long-term renal outcomes in patients with primary aldosteronism.
Sechi et al.
JAMA 2006;295:2638-2645.
ABSTRACT
| FULL TEXT
Abnormalities of Glucose Metabolism in Patients With Early Renal Failure
Sechi et al.
Diabetes 2002;51:1226-1232.
ABSTRACT
| FULL TEXT
Relationship of Fibrinogen Levels and Hemostatic Abnormalities With Organ Damage in Hypertension
Sechi et al.
Hypertension 2000;36:978-985.
ABSTRACT
| FULL TEXT
Are Retinal Arteriolar Abnormalities Related to Atherosclerosis? : The Atherosclerosis Risk in Communities Study
Klein et al.
Arterioscler. Thromb. Vasc. Bio. 2000;20:1644-1650.
ABSTRACT
| FULL TEXT
Lipoprotein(a) Serum Concentrations and Apolipoprotein(a) Phenotypes in Mild and Moderate Renal Failure
KRONENBERG et al.
J. Am. Soc. Nephrol. 2000;11:105-115.
ABSTRACT
| FULL TEXT
Increased Serum Lipoprotein(a) Levels in Patients with Early Renal Failure
Sechi et al.
ANN INTERN MED 1999;130:1028-1029.
FULL TEXT
Lipid and Apolipoprotein Predictors of Atherosclerosis in Youth : Apolipoprotein Concentrations Do Not Materially Improve Prediction of Arterial Lesions in PDAY Subjects
Rainwater et al.
Arterioscler. Thromb. Vasc. Bio. 1999;19:753-761.
ABSTRACT
| FULL TEXT
Emerging Noninvasive Biochemical Measures to Predict Cardiovascular Risk
Pahor et al.
Arch Intern Med 1999;159:237-245.
ABSTRACT
| FULL TEXT
|
