The Anatolian Journal of Cardiology

[Anatol J Cardiol]
Anatol J Cardiol. 2013; 13(4): 306-314 | DOI: 10.5152/akd.2013.106  

Increased apolipoprotein A-I levels mediate the development of prehypertension among Turks

Altan Onat1, Günay Can2, Ender Örnek3, Gökhan Çiçek4, Sani N. Murat5, Hüsniye Yüksel6
1Department of Cardiology, Turkish Society of Cardiology, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
2Department of Public Health, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul- Turkey
3Clinic of Cardiology, Etlik İhtisas Education Hospital, Ankara-Turkey
4Clinic of Cardiology, Siyami Ersek Center for Cardiovascular Surgery, İstanbul-Turkey
5Clinic of Cardiology, Etlik Ihtisas Educational Hospital, Ankara-Turkey
6Department of Cardiology, Turkish Society of Cardiology Cerrahpaşa Medical Faculty, İstanbul-Turkey

Objective: We aimed to assess whether apolipoprotein (apo) A-I levels that generated type-2 diabetes and coronary disease among Turks contribute to prehypertension and hypertension. Methods: A population-based sample of 2207 adults (mean age 53±11 years) was studied prospectively over a 6.5 years’ follow-up. Individuals with hypertension and/or prehypertension were excluded at baseline. Results: At baseline, levels of apoA-I increased in each sex, from the normotensive to prehypertensive and hypertensive group (by mean 7.6 mg/dL, p<0.001) concomitantly with age, waist circumference, fasting triglycerides, apoB, C-reactive protein (CRP) and homeostasis model assessment. In logistic regression models, adjusted for confounders comprising waist circumference or triglycerides, prehypertension was predicted independently by apoA-I at RRs of 1.23 (95%CI 0.97; 1.52)] or 1.32 (95%CI 1.04; 1.74), respectively. Despite showing a positive association, apoA-I did not independently predict in similar models the development of hypertension; the determinants were rather waist circumference, or fasting triglycerides or CRP [RR 1.16 (95%CI 1.05; 1.28)] and, in women, diabetes. In a linear regression analysis for circulating apoA-I including 10 variables, apoB and in men systolic blood pressure were positively associated. Conclusion: In contributing to prehypertension, the pro-inflammatory apoA-I, mediated by apoB, is independent of triglyceridemia. Other inflammatory processes conjointly are likely mechanistically involved in the development of hypertension in a population with prevalent metabolic syndrome.

Keywords: Apolipoproteins, C-reactive protein, diabetes type-2, obesity, prehypertension, systemic inflammation, regression analysis

Altan Onat, Günay Can, Ender Örnek, Gökhan Çiçek, Sani N. Murat, Hüsniye Yüksel. Increased apolipoprotein A-I levels mediate the development of prehypertension among Turks. Anatol J Cardiol. 2013; 13(4): 306-314

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