ASSOCIATION BETWEEN BLOOD LIPOPROTEIN(A) LEVELS AND BLOOD PRESSURE PARAMETERS IN A KOREAN POPULATION

초록

Background and Aims: Lipoprotein(a) [Lp(a)] has been known to be a residual cardiovascular risk factor. Biologically, Lp(a) is hydrophilic and interacts directly with the endothelial surface, affecting endothelial dysfunction, vascular smooth muscle cell proliferation, and cytokine production. In this aspect, it is also hypothesized to be associated with hemodynamic factors such as blood pressure. However, the relationship between hemodynamic factors and blood Lp(a) levels remains unclear. This study aimed to investigate the association between blood Lp(a) levels and blood pressure (BP) parameters, including systolic BP, diastolic BP, and BP variability. Methods: Patients over 18 years of age who had Lp(a) measured and office BP recorded three or more times over two years were analyzed from three tertiary hospitals in South Korea between January 1, 2019, and June 30, 2020. Results: A total of 7,031 patients were identified, of which 5,238 (74.5%) had hypertension. The analysis showed little correlation between Lp(a) levels and hemodynamic parameters. The highest correlation coefficient was -0.06 with mean diastolic BP, and the lowest was -0.01 with mean systolic BP. The 3-year major adverse cardiovascular event (MACE) incidence was higher in patients with elevated blood Lp(a) levels. However, in the time-dependent ROC curve analysis for MACE, the AUC for Lp(a) level was 0.544, lower than the BP variability AUC of 0.602 (p-value < 0.01). Conclusions: In conclusion, while blood Lp(a) levels are a significant cardiovascular risk factor, they show minimal association with BP parameters.