Abstract
Lipoprotein(a) [Lp(a)] is known to provoke atherosclerosis and has been confirmed as a major independent risk factor for cardiovascular and cerebrovascular diseases. At the same time, patients with hypertension (HT) are prone to develop atherosclerosis. Calcium antagonists have been shown to have antiatherosclerotic properties in addition to their vasodilatory and antihypertensive effects. We therefore investigated the effect of nisoldipine (Ni), a calcium antagonist, on plasma Lp(a) levels in HT patients.
(1) Plasma Lp(a) concentration was determined by ELISA for 59 (19 males and 40 females) untreated HT patients (group A; age: 32-74, mean 54 years) and found to be 19.1±2.2mg/dl (Mean±S. E.: range from 1.1 to 101.0). This was higher than the value of 11.8±0.8 (range from 0.2 to 46.1) determined for 106 (34 males and 72 females) healthy subjects in the same age range (group B; age: 30-75, mean 50 years, p<0.002). In addition, there was a higher incidence of Lp(a) levels above 25mg/dl in group A than in group B (28.8% and 6.6%, respectively; p<0.001).
(2) The mean plasma Lp(a) level of 113 patients (53 males and 60 females) treated for HT with calcium antagonists and/or ACE inhibitors (group C; age: 33-74, mean 58 years) was 14.1±1.2mg/dl (range from 0.4 to 76.0). This value was lower than that of group A and was not significantly different from that of group B. 14.2% of group C had high (i. e.>25mg/dl) Lp(a) levels, which was significantly lower than that of group A (p<0.025), but not significantly different from group B.
(3) Following Ni administration to the 32 patients in group A, Lp(a) value for the group declined to 15.8±2.0mg/dl (range from 3.2 to 45.9). The percentage of cases with high levels also decreased to 15.6%, close to that for group C.
In conclusion, while high plasma Lp(a) levels were observed in group A, group C tended to have levels lower than A and not different from B. Lp(a) levels in the A+Ni group followed a similar pattern in group C.
