A combination of bad cholesterol and high blood pressure may increase the risk of heart attack and stroke

Research highlights:

• A study of more than 6,000 men and women in the United States found that, in addition to high blood pressure, elevated levels of lipoprotein(a), a type of “bad” cholesterol, were associated with cardiovascular disease and heart disease. It has been found to increase the risk of developing major cardiovascular events such as vascular disease. As a heart attack or stroke during 14 years of follow-up.
• The researchers found that hypertension plus elevated lipoprotein(a) levels above 50 mg/dL was associated with more cardiovascular disease and major cardiovascular events than hypertension alone. found to be at increased risk.

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Dallas, December 13, 2022 — High levels of lipoprotein(a), a type of ‘bad’ cholesterol, may increase the risk of cardiovascular disease in people with high blood pressure by 18-20%, but may increase the risk of CVD. Risk was not.higher among people without high blood pressure, according to a new study published today in high blood pressureJournal of the American Heart Association.

“High blood pressure is a known risk factor for cardiovascular disease, and lipoprotein(a) is a type of hereditary ‘bad’ cholesterol that can lead to cardiovascular disease,” said the study’s lead author, Cardiovascular Medicine. said medical fellow Rishi Rikhi, M.D., Ph.D. At Atrium Health Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. “Among people with hypertension who have never had a stroke or heart attack, lipoprotein(a) appears to increase the risk of cardiovascular disease and major cardiovascular events such as heart attack and stroke. I discovered what seems to be

High blood pressure is an important risk factor cardiovascular diseaseIn this study, hypertension was defined as a highest value of 140 mmHg or higher, a lowest value of 90 or mmHg, or use of blood pressure medication. updated its definition High blood pressure with a maximum value of 130 mmHg or more or a minimum value of 80 mmHg or more. Previous studies have shown that the risk of cardiovascular disease increases significantly if a person has high blood pressure and a lipid imbalance, or dyslipidemia. There is little information on the extent to which a) affects cardiovascular disease risk in hypertensive patients.

Lipoproteins, which are made up of proteins and fats, carry cholesterol through the blood. Lipoprotein subtypes include low-density lipoprotein (LDL), high-density lipoprotein (HDL), and lipoprotein(a) or Lp(a).very similar LDL-cholesterollipoprotein(a) cholesterol deposits and accumulates in the walls of blood vessels, which can increase the risk of heart attack and stroke.

This study used health data from the Multi-Ethnic Study of Atherosclerosis (MESA) study. This is an ongoing, community-based, asymptomatic cardiovascular disease study in the United States that means disease is detected before clinical signs and symptoms appear. MESA is a research study of approximately 7,000 adults that began in 2000 and still tracks participants at his six locations in the United States. Chicago; New York; Los Angeles County, California. Forsyth County, North Carolina. St. Paul, Minnesota. All participants were free of cardiovascular disease at study enrollment.

The current study assessed lipoprotein(a) levels and blood pressure and included MESA follow-up examinations and telephone cardiovascular event data in approximately 2001, 2003, 2004, 2006, 2010, and 2017. included 6,674 MESA participants with a recorded . Interviews will be conducted every 9-12 months to collect interim data on new diagnoses, procedures, hospitalizations and deaths. Participants in this study were from various racial and ethnic groups. 27.5% identified as African American adults. 22.1% self-identified as Hispanic adults. 11.9% identified as Chinese American (n=791) adults. Additionally, more than half of the group was female (52.8%).

To assess the potential correlation between hypertension and lipoprotein(a) in the development of cardiovascular disease, researchers first assessed participants’ lipoprotein(a) levels and blood pressure measurements obtained once at baseline. categorized into groups based on

• Group 1 (n = 2,837): Lipoprotein(a) levels less than 50 mg/dL and no hypertension.
• Group 2 (n = 615): Lipoprotein(a) level ≥50 mg/dL and no hypertension
• Group 3 (n = 2,502): Lipoprotein(a) levels <50 mg/dL and hypertension
• Group 4 (n = 720): Lipoprotein(a) levels ≥ 50 mg/dL and hypertension

Participants were followed for an average of approximately 14 years, heart attack, cardiac arrestwere followed for death from stroke or coronary artery disease.

Findings from this survey include:

• A total of 809 participants experienced a cardiovascular event.
• Lipoprotein(a) levels had a statistically significant effect on hypertensive status (meaning it was not due to chance).
• There was no increased risk of cardiovascular disease events in group 2 (high lipoprotein(a) levels, no hypertension) compared to group 1 (low lipoprotein(a) levels, no hypertension). did.
• Fewer than 10% of group 1 (7.7%) and group 2 (8% of participants) experienced a cardiovascular disease event.
• All participants in groups 3 and 4 were hypertensive and showed a statistically significant increased risk of cardiovascular disease events compared to group 1 participants.
• Approximately 16.2% of people in group 3 (low lipoprotein (a) levels and hypertension) experienced a cardiovascular disease event, and 18.8% of participants in group 4 (high lipoprotein (a) levels and hypertension) had cardiovascular events. experienced a disease event.

“We found that the overwhelming amount of cardiovascular risk in this diverse population is due to hypertension,” said Rikhi. “In addition, elevated lipoprotein(a) increased cardiovascular risk in hypertensives. The fact that lipoprotein(a) appears to alter the relationship between hypertension and cardiovascular disease is intriguing.” , suggesting an important interaction or relationship between hypertension, lipoprotein(a), and cardiovascular disease and warrants further study.”

Anyone can improve their cardiovascular health by following American Heart Association Life’s Essential 8: Healthy eating, physical activity, smoking cessation, getting enough sleep, maintaining a healthy weight, and controlling cholesterol, blood sugar, and blood pressure. Cardiovascular disease claims more lives in the United States each year than all forms of cancer and chronic lower respiratory tract disease combinedaccording to the American Heart Association.

This study had limitations, including potential selection biases from participants (potentially unbalanced from one of the four subgroups), which could have resulted in dropouts due to the study’s length. . Additionally, study participants may have developed hypertension during the follow-up period, which may have led to misclassification.

Co-author is Harpreet S. Bhatia, MD. Dr. Christopher Shaich. Nicklaus Ashburn, MD, MS. David Herrington, MD, MPH. Dr. Michael Y. Tsai. Erin D. Mikos, MD, MHS. Parag Chevli, MBBS, MS; Sotirios Tsimikas, M.D.; and Michael D. Shapiro, DO, MCR. Author disclosures are provided in the manuscript.

This study was funded through grants from the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health, and the National Center for Advanced Translational Sciences.

Research statements and conclusions published in the American Heart Association scientific journal are those of the study authors only and do not necessarily reflect the policies or positions of the association. The Association makes no representations or warranties as to their accuracy or reliability. The association receives funding primarily from individuals. Foundations and companies (including pharmaceuticals, device manufacturers, and other companies) also make donations to fund specific programs and events of the association. The Society has strict policies to prevent these relationships from affecting the content of science. Income from pharmaceutical companies, biotech companies, device manufacturers, health insurers, and the association’s overall financial information are available. here.

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