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Reducing Blood Pressure Could Save Your Life

A combo platter of high blood pressure and an elevated lipoprotein could put some at risk for heart attacks, strokes, and death due to heart disease according to new research.

A subtype of lipoprotein, known as lipoprotein (a) can clog up arteries and raise the risk of heart attack and stroke. Lipoproteins are made of protein and fat and transport cholesterol through your blood. Unlike other types of lipoproteins, lipoprotein (a) is not impacted by lifestyle but by heredity.

In individuals with normal blood pressure, elevated levels of lipoprotein (a) did not increase the risk of cardiovascular occurrences, based on a study published in Hypertension, a journal of the American Heart Association.

Cardiovascular risk was seen primarily in those with high blood pressure and was even higher when lipoprotein (a) was high, according to lead study author Dr. Rishi Rikhi, a cardiovascular medicine fellow at Atrium Health Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.

Hypertension is a known risk factor for heart disease but becomes more of an issue when a person has dyslipidemia, such as high cholesterol. Rikhi’s study used health data from the Multi-Ethnic Study of Atherosclerosis.

The 6,674 participants were divided into four groups: individuals with lipoprotein(a) levels less than 50 mg/dl and no hypertension; individuals with lipoprotein(a) levels of 50 mg/dl or higher and no hypertension; those with levels less than 50 mg/dl and hypertension; and people with levels 50 mg/dl or higher and hypertension.

Study subjects came from racially diverse groups in Baltimore; Chicago; New York; Los Angeles County; Forsyth County, North Carolina; and St. Paul, Minnesota. The subjects did not have cardiovascular disease when the study started in 2000. They were followed over an average of 14 years for any cardiovascular events, such as heart attacks, strokes, cardiac arrest, and death from coronary artery disease.

The American Heart Association has defined high blood pressure as a top number of 130 mmHg or higher or a bottom number of 80 mmHg or above since 2017. For this study, researchers used a top number of 140 mmHg or a bottom number of 90 mmHg or higher, or if an individual took medication to manage blood pressure.

According to the study, lipoprotein (a) alone didn’t raise the risk for cardiovascular events. Still, when combined with high blood pressure, a higher risk was noted when more lipoprotein (a) was measured.

In those with high lipoprotein (a) but without hypertension, there was no increased risk for cardiovascular events compared to those with low lipoprotein (a) and no hypertension.

An increase in cardiovascular risk was observed in both groups with high blood pressure, whether lipoprotein (a) was high or not. In those with lower lipoprotein (a), 16.2% experienced cardiovascular events, and 18.8% did when they had elevated lipoprotein (a) levels.

If you have elevated lipoprotein (a), controlling your blood pressure is important to prevent cardiovascular events. Below are tips to reduce your cardiovascular risks:

1.        Know your numbers. Get blood pressure and lipoprotein (a) levels checked regularly.

2.      Follow the DASH diet(2). Include plenty of fruits, vegetables, whole grains, lean protein, and low-fat dairy products in your diet.

3.      Exercise regularly to manage weight, stress, and blood pressure.

4.     Reduce sodium in your diet by cutting back on fast food, processed food, cured meats, salty snacks, and convenience foods.

5.      Cut back on foods high in saturated fat, including fatty cuts of beef and pork, fried foods, whole milk dairy products, and high-fat desserts.

6.      Limit alcohol consumption, as too much raises blood pressure.

7.      Get adequate sleep to control blood pressure.

8.     Take medication as prescribed to control blood pressure and lipids.

Here is a handout for heart month.

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References:

1.        This type of cholesterol could be bad in people with high blood pressure | American Heart Association

2.      DASH Eating Plan | NHLBI, NIH

Lisa Andrews, MEd, RD, LD