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Low-density lipoprotein subfractions and cardiovascular risk in hypertension: relationship to endothelial dysfunction

Dirk C Felmeden1, Charles G C Spencer, Andrew D Blann

  • 1Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.

Hypertension (Dallas, Tex. : 1979)
|March 8, 2003
PubMed

Insights

Hypertensive patients exhibit abnormal LDL subfractions and impaired endothelial function, increasing vascular risk. Cardiovascular risk management improved these markers, highlighting their link to overall cardiovascular health.

Area of Science:

  • Cardiovascular Medicine
  • Lipidology
  • Vascular Biology

Background:

  • Hypertension is a major risk factor for vascular complications.
  • The roles of atherogenic lipoprotein profiles and endothelial dysfunction in this risk are not fully understood.
  • Investigating these factors in high-risk hypertensive patients is crucial for understanding disease mechanisms.

Purpose of the Study:

  • To assess LDL subfractions and flow-mediated dilation (FMD) in hypertensive patients.
  • To determine the relationship between atherogenic lipoproteins, endothelial dysfunction, and cardiovascular risk.
  • To evaluate the impact of cardiovascular risk factor management on these parameters.

Main Methods:

  • Studied 84 high-risk hypertensive patients and 61 healthy controls.
  • Analyzed LDL subfractions using disc polyacrylamide gel electrophoresis to derive an LDL score.
  • Assessed endothelial function via flow-mediated dilation (FMD) of the brachial artery using high-resolution ultrasound.

Main Results:

  • Hypertensive patients had significantly higher LDL scores and impaired FMD compared to controls.
  • LDL score correlated positively with the 10-year Framingham coronary heart disease risk score.
  • FMD showed a significant negative correlation with LDL score and cardiovascular risk.
  • These abnormalities improved after 6 months of cardiovascular risk factor management.

Conclusions:

  • Hypertension is associated with both abnormal atherogenesis (indicated by LDL score) and endothelial dysfunction (impaired FMD).
  • These factors are interrelated and contribute to the increased vascular risk in hypertensive individuals.
  • Cardiovascular risk management can positively influence atherogenic lipoprotein profiles and endothelial function, reducing overall cardiovascular risk.

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