Although emerging data suggest that circulating lipoprotein (a) [Lp (a)] could predict cardiovascular events (CVEs) in patients with cardiovascular disease, no study is currently available regarding the prognostic linkage of Lp (a) and hypertension in patients with coronary artery disease (CAD). This study sought to evaluate the association of Lp (a), hypertension and cardiovascular outcomes in patients with stable CAD. A total of 8668 patients with stable CAD were consecutively enrolled. Baseline Lp (a) concentrations were measured. All subjects were categorized according to Lp (a) levels of <10 (low), 10–30 (medium) and ≥30 mg/dL (high) and were further stratified by hypertension status. They were regularly followed-up for the occurrence of cardiovascular death, nonfatal myocardial infarction, and stroke. Over an average of 54.81 ± 18.60 months of follow-up, 584 (6.7%) CVEs occurred. Kaplan–Meier and multivariate Cox regression analyses showed that elevated Lp (a) levels had a significant association with CVEs in hypertensive patients, regardless of the control status of blood pressure, but not in normotensive subjects. Moreover, when analyzed by subgroups according to both Lp (a) category and hypertension status, the risk of CVEs was only significantly elevated in the high Lp (a) plus hypertension group compared with the reference group with low Lp (a) levels and normotension (hazard ratio: 1.80, 95% confidence interval: 1.11–2.91). Elevated Lp (a) was associated with an increased risk of CVEs in stable CAD patients with hypertension. Moreover, the coexistence of high Lp (a) concentrations and hypertension greatly worsened the clinical prognosis in patients with CAD, which may suggest a prognostic correlation between Lp (a) and hypertension.

尽管新数据表明循环脂蛋白 (a) [Lp (a)] 可以预测心血管疾病患者的心血管事件 (CVE)，但目前尚无关于 Lp (a) 与冠状动脉患者高血压的预后联系的研究疾病（CAD）。本研究旨在评估稳定型 CAD 患者 Lp (a)、高血压和心血管结局之间的关联。连续招募了 8668 名稳定型 CAD 患者。测量基线 Lp (a) 浓度。所有受试者均根据<10（低）、10-30（中）和≥30 mg/dL（高）的Lp（a）水平进行分类，并按高血压状态进一步分层。他们定期随访心血管死亡、非致死性心肌梗死和中风的发生情况。平均超过 54.81 ± 18。在 60 个月的随访中，发生了 584 例 (6.7%) CVE。Kaplan-Meier 和多变量 Cox 回归分析表明，无论血压的控制状态如何，升高的 Lp (a) 水平与高血压患者的 CVE 显着相关，但在血压正常的受试者中则不然。此外，当根据 Lp (a) 类别和高血压状态进行亚组分析时，与 Lp (a) 水平低且血压正常的参考组相比，高 Lp (a) 加高血压组的 CVE 风险仅显着升高（风险比：1.80，95% 置信区间：1.11–2.91）。升高的 Lp (a) 与患有高血压的稳定型 CAD 患者的 CVE 风险增加有关。此外，高 Lp (a) 浓度和高血压的共存大大恶化了 CAD 患者的临床预后，