{"id":"a45b08894c21","type":"article","url":"https://hartvaat.nl/2026/06/01/hypertensie-wijzigt-de-relatie-tussen-lp-a-en-mortaliteit-bij-acuut-gedecompense/","title":"Hypertensie wijzigt de relatie tussen Lp(a) en mortaliteit bij acuut gedecompenseerd hartfalen","title_en":"Impact of hypertension on associations of all-cause mortality with admission lipoprotein (a) in acute decompensated heart failure.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","anemie-ckd","bisoprolol","bloeddrukbehandeling","dyslipidemie","ezetimibe","hypertrofische-cardiomyopathie","ijzertekort","laminopathie","ldl-cholesterol","lipide-aferese","lipoproteïne-a","lipoproteïne-a-therapeutisch-doel","myocardinfarct","nt-probnp","pelacarsen","sacubitril-valsartan","vrouwen"],"journal":"International journal of cardiology. Cardiovascular risk and prevention","doi":"10.1016/j.ijcrp.2026.200594","source_url":"https://doi.org/10.1016/j.ijcrp.2026.200594","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"],"significance":4,"published":"2026-03-01","source_date":"2026-06-01","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/farmacologie/aldosteron-en-raas-farmacologie/"],"congress":"","summary_en":"This study demonstrates that hypertension modifies the prognostic value of lipoprotein(a) in patients with acute decompensated heart failure, with the Lp(a)-mortality association differing by blood pressure status.","created":"2026-07-03T10:24:55Z","updated":"2026-07-03T18:38:09Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Bij patiënten met acuut gedecompenseerd hartfalen beïnvloedt de aanwezigheid van hypertensie de prognostische waarde van lipoproteïne(a). De studie laat zien dat de associatie tussen Lp(a) en sterfte verschilt naargelang de bloeddrukstatus, wat implicaties heeft voor risicostratificatie.","abstract_original":"BACKGROUND AND AIMS: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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."}