Impact of hypertension on associations of all-cause mortality with admission lipoprotein (a) in acute decompensated heart failure.

Authors

Ashen L Vidanage, Tianyu Xu, Zihao Chen, Zhongping Yu, Chang Chen, Shilan Chen, Wengen Zhu, Jiangui He, Yugang Dong, Chen Liu, Jingjing Zhao, Fang-Fei Wei

Published in

International journal of cardiology. Cardiovascular risk and prevention. Volume 29. Pages 200594. Epub Feb 07, 2026.

Abstract

Serum lipoprotein(a) [Lp(a)] is recognized as an independent risk factor for cardiovascular disease. However, whether hypertension modifies the association between Lp(a) and adverse outcomes in acute decompensated heart failure (ADHF) remains unclear. We investigated how hypertension status influences the relationship between Lp(a) and all-cause mortality in ADHF.
We conducted a single-center retrospective observational study including 2610 patients hospitalized with ADHF. We normalized the distribution of Lp(a) by a logarithmic transformation and assessed the risk of all-cause mortality with Lp(a), using Cox regression with adjustment for potential confounders.
Among 2610 patients (39.0% women; mean age, 68.8 years), 1606 (61.5%) had hypertension. Over 4.1 years (median), 1287 deaths occurred. In all patients, log-transformed Lp(a) was significantly associated with mortality (adjusted HR 1.21; 95% CI, 1.05-1.39; P = 0.007), with the highest tertile showing increased risk compared to the lowest tertile (HR 1.19; 95% CI, 1.03-1.37; P = 0.016). In ADHF combined with hypertension, Lp(a) conferred higher risk of mortality (HR, 1.35; 95% CI, 1.13-1.62; P = 0.001); and the highest tertile of Lp(a) was associated with higher risk of mortality (HR, 1.33; 95% CI, 1.11-1.59; P = 0.002) compared with the lowest tertile. However, there were no associations between mortality and Lp(a) in those without hypertension (P ≥ 0.41). The interaction between hypertension with Lp(a) was significant for mortality (P = 0.002).
Increased admission Lp(a) levels were associated with a higher risk of all-cause mortality in ADHF patients with hypertension. Further studies are needed to explore the mechanistic links among Lp(a), hypertension and ADHF.

PMID:
41732490
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

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