title: Increased apolipoprotein A-I levels mediate the development of prehypertension among Turks.
abstract: OBJECTIVE
  We aimed to assess whether apolipoprotein (apo) A-I levels that generated type-2 diabetes and coronary disease among Turks contribute to prehypertension and hypertension.
  
  
  METHODS
  A population-based sample of 2207 adults (mean age 53±11 years) was studied prospectively over a 6.5 years' follow-up. Individuals with hypertension and/or prehypertension were excluded at baseline.
  
  
  RESULTS
  At baseline, levels of apoA-I increased in each sex, from the normotensive to prehypertensive and hypertensive group (by mean 7.6 mg/dL, p<0.001) concomitantly with age, waist circumference, fasting triglycerides, apoB, C-reactive protein (CRP) and homeostasis model assessment. In logistic regression models, adjusted for confounders comprising waist circumference or triglycerides, prehypertension was predicted independently by apoA-I at RRs of 1.23 (95%CI 0.97; 1.52)] or 1.32 (95%CI 1.04; 1.74), respectively. Despite showing a positive association, apoA-I did not independently predict in similar models the development of hypertension; the determinants were rather waist circumference, or fasting triglycerides or CRP [RR 1.16 (95%CI 1.05; 1.28)] and, in women, diabetes. In a linear regression analysis for circulating apoA-I including 10 variables, apoB and in men systolic blood pressure were positively associated.
  
  
  CONCLUSIONS
  In contributing to prehypertension, the pro-inflammatory apoA-I, mediated by apoB, is independent of triglyceridemia. Other inflammatory processes conjointly are likely mechanistically involved in the development of hypertension in a population with prevalent metabolic syndrome.
authors.affiliation: Department of Cardiology, Turkish Society of Cardiology Cerrahpaşa Medical Faculty, İstanbul-Turkey. alt_onat@yahoo.com.tr
authors.forename: Altan
authors.initials: A
authors.lastname: Onat
authors.forename: Günay
authors.initials: G
authors.lastname: Can
authors.forename: Ender
authors.initials: E
authors.lastname: Örnek
authors.forename: Gökhan
authors.initials: G
authors.lastname: Çiçek
authors.forename: Sani N
authors.initials: SN
authors.lastname: Murat
authors.forename: Hüsniye
authors.initials: H
authors.lastname: Yüksel
mesh_terms: D000367:Age Factors; D016632:Apolipoprotein A-I / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012737:Sex Factors; D014421:Turkey / Q000453:epidemiology
chemical_list: D016632:Apolipoprotein A-I; D015415:Biomarkers