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Relationship of Early Carotid Artery Disease With Lipoprotein (a), Apolipoprotein B, and Fibrinogen in Asymptomatic Essential Hypertensive Patients and Normotensive Subjects
  1. Alberto Rossi,
  2. Goretta Baldo-Enzi,
  3. Chiara Ganzaroli,
  4. Giovanna Coscetti,
  5. Alessio Calabrò,
  6. Maria Rosa Baiocchi,
  7. Giuseppe Maiolino,
  8. Achille C. Pessina,
  9. Gian Paolo Rossi
  1. From the Department of Internal Medicine Clinica Medica 1 and Department of Clinical & Experimental Medicine Clinica Medica 4, University of Padua, Padua, Italy.
  1. Address correspondence to: Gian Paolo Rossi, MD, FACC, Clinica Medica 4, University Hospital, via Giustiniani, 2, 35126 Padua, Italy. E-mail gianpaolo.rossi{at}unipd.it
  2. Supported by research grants of the Italian Ministry of University and Scientific Research (MURST) to A.C.P. (9906193152_001/06) and by research grants from the University of Padua (1999/043/2/14/05/002) and from Regione Veneto to G.P.R. (863/01/98).

Abstract

Background We investigated the relationships between plasma lipids and lipoprotein fractions and carotid artery lesions (CAL) in 177 cerebro-vascularly asymptomatic subjects, of whom 107 were primary hypertensive patients and 70 normotensive controls.

Methods The prevalence and severity of CAL, as assessed by calculating a score of severity (score of CAL) and the maximal stenosis of both sides, as well as the intimal-medial thickness (IMT) were evaluated with a high-resolution echo-Doppler technique. We measured total serum cholesterol, triglycerides, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, lipoprotein (a) [Lp(a)], Apo (apolipoprotein)AI, ApoAII, ApoB, and fibrinogen.

Results Both the prevalence (59.4% vs 26.2%) and severity of sex- and age-adjusted and unadjusted CAL and IMT were significantly higher in hypertensive patients than in controls. Regression analysis showed different predictors of IMT and maximal stenosis. The variables that remained in the model were age, mean blood pressure (BP), and smoking for IMT; pulse pressure, known duration of hypertension (HT), fibrinogen, and ApoB for the score of CAL; and the last four variables along with age and mean BP for maximal stenosis. Furthermore, we identified a link between the atherogenic lipoprotein fractions Lp(a) and ApoB, fibrinogen and early carotid artery atherosclerotic changes.

Conclusions The different correlates of IMT, CAL, and maximal degree of stenosis suggest that they reflect different events occurring in the arterial wall in response to aging, HT, and other risk factors, rather than simply different stages of the same atherosclerotic process.

Keywords
  • cerebrovascular disorders
  • hypertension
  • carotid artery lesions
  • ultrasound imaging
  • cholesterol
  • lipids
  • lipoproteins
  • fibrinogen

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