Elevated lipoprotein(a) levels are associated with adverse left ventricular geometric remodeling in non-diabetic patients with essential hypertension.

BACKGROUND

Lipoprotein(a) [Lp(a)] is an established cardiovascular risk factor associated with inflammation, endothelial dysfunction, oxidative stress, and arterial stiffness. Although elevated Lp(a) levels are linked to cardiovascular disease, their association with left ventricular (LV) geometric remodelling in hypertension remains incompletely understood. This study aimed to evaluate the relationship between serum Lp(a) levels and LV geometry in non-diabetic patients with essential hypertension.

METHODS

This cross-sectional observational study included 110 non-diabetic patients with essential hypertension. Patients were classified into low Lp(a) (<50 mg/dL, n=70) and elevated Lp(a) (≥50 mg/dL, n=40) groups. Comprehensive transthoracic echocardiography was performed to assess LV mass index (LVMI), relative wall thickness, and LV geometric patterns. Correlation and multivariate regression analyses were used to determine the independent association between Lp(a) levels and LV remodelling parameters.

RESULTS

Patients with elevated Lp(a) levels had significantly higher LVMI compared with those with lower levels (139.6±28.5 vs. 117.6±24.2 g/m², p<0.001). Concentric LV hypertrophy was more prevalent in the elevated Lp(a) group (55.0% vs. 20.0%, p=0.001). Serum Lp(a) levels were positively correlated with LVMI (r=0.357, p<0.001) and remained independently associated with LVMI after adjustment for clinical confounders (β=0.363, p<0.001). Elevated Lp(a) levels were also independently associated with increased odds of concentric LV hypertrophy.

CONCLUSIONS

Elevated serum Lp(a) levels are independently associated with adverse LV geometric remodelling and concentric hypertrophy in non-diabetic patients with essential hypertension. Measurement of Lp(a) may provide additional information for cardiovascular risk stratification and early identification of hypertensive patients at risk for target organ damage.