Abstract P109: Hypertension in a Large Cohort of Patients With Lipoprotein(a) at a Tertiary Academic Center

Background: Recently, guidelines have recognized elevated Lp(a) as a clinical risk factor significantly and independently associated with cardiovascular disease (CVD). Another important CVD risk factor, hypertension, has been well-described. However, few real-world studies that explore the association between lipoprotein(a) and hypertension have been conducted. Objective: To evaluate hypertension in patients with serum lipoprotein(a) [Lp(a)] at a large tertiary academic center. Methods: The University of Pennsylvania Health System was queried for all patients with an Lp(a) result between 1999-2019. The first Lp(a) result was chosen for patients with multiple Lp(a) results. In this cohort of patients, the presence of hypertension was queried by hypertension ICD-9 and ICD-10 codes. The cohort was stratified by Lp(a) tertile and the presence of hypertension was evaluated. A chi-squared analysis was performed to test for association between Lp(a) tertile and presence of hypertension. Results: The query returned a cohort of 8120 patients with a median and interquartile range of Lp(a) of 22 mg/dL and 8-64 mg/dL, respectively. The cohort had a median age of 54 years, 54% (n=4379) were men, and 21% (n=1705) were non-white. Hypertension was reported in 51% (n=4155) of patients. The tertile with low Lp(a) [median, 6 mg/dL; IQR, 4-8 mg/dL] had hypertension in 50.1% (n=1357) of patients. The tertile with moderate Lp(a) [22 mg/dL, 16-33 mg/dL] had hypertension in 50.5% (n=1367) of patients. The tertile with high Lp(a) [84 mg/dL, 64-116 mg/dL] had hypertension in 51.0% (n=1381) of patients. The association between Lp(a) tertile and presence of hypertension was insignificant ( p-value, 0.81). Conclusions: In this real-world cohort, the data suggest that Lp(a) and hypertension are not associated. New clinical trials that test Lp(a)-lowering pharmacotherapies may enable further characterization of the association between Lp(a) and hypertension in order to inform CVD prevention.