title: Association of serum lipoprotein(a) levels and apolipoprotein(a) size polymorphism with target-organ damage in arterial hypertension.
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.
  
  
  METHODS
  Cross-sectional study of a case series.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Hypertension Unit, Department of Internal Medicine, University of Udine School of Medicine, Italy. Sechiuniud.it.
authors.forename: L A
authors.initials: LA
authors.lastname: Sechi
authors.forename: F
authors.initials: F
authors.lastname: Kronenberg
authors.forename: S
authors.initials: S
authors.lastname: De Carli
authors.forename: E
authors.initials: E
authors.lastname: Falleti
authors.forename: L
authors.initials: L
authors.lastname: Zingaro
authors.forename: C
authors.initials: C
authors.lastname: Catena
authors.forename: G
authors.initials: G
authors.lastname: Utermann
authors.forename: E
authors.initials: E
authors.lastname: Bartoli
mesh_terms: D000328:Adult; D001054:Apolipoproteins A / Q000235:genetics*; D001161:Arteriosclerosis / Q000453:epidemiology* / Q000235:genetics; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000235:genetics; D003430:Cross-Sectional Studies; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000235:genetics* / Q000503:physiopathology*; D008055:Lipids / Q000097:blood; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010641:Phenotype; D011110:Polymorphism, Genetic; D012307:Risk Factors
chemical_list: D001054:Apolipoproteins A; D008055:Lipids; D017270:Lipoprotein(a)