**2.3. Results**

spectrum phenotype B (vs. phenotype A) in these four representatives of cardiovascular diseases was identified. At the same time, a lipoprotein spectrum of a control group of healthy

Arterial hypertension (AH) (Fig. 3) is one of the most serious cardiovascular diseases. More than 20% of the adult population suffers from this disease. AH is one of the risk factors for atherosclerosis development of coronary, brain, and peripheral arteries, together with the main cardinal risk factors, that is, dyslipoproteinemia and tobacco smoking [14,20,38]. Atherogenic LDL subfractions also play a role in the development of the arterial hypertension [32, 43].

AH is a permanent, long-lasting increase in blood pressure of more than 140/90 mmHg in people of middle age. In people older than 70 years of age, values higher than 160/95 mmHg are considered increased. For more extensive guidelines see the Statement of WHO/ISH

Dyslipoproteinemia, which frequently accompanies AH and multiplies the risk of athero‐ sclerosis development, can also be considered one of the multiple sources that give rise to

Atherogenic lipoproteins in plasma cause endothelial dysfunction, increase vessel tone, and support the development of AH, which terminates in organ ischemia [8,50,51,55,57,59].

In our study 107 patients with newly diagnosed arterial hypertension were examined. Repeated blood pressure (BP) examination confirmed an increased blood pressure more than 150 mmHg for systolic and more than 90 mmHg for diastolic blood pressure in all hypertensive patients. Average systolic blood pressure was 172 ±19 mmHg and average diastolic blood pressure was 102 ±10 mmHg. The group of hypertensive patients comprised 66 men and 41 women. The average age of the men was 50 ± 17.6 years and the average age of the women

The control group consisted of 150 healthy normotensive and normolipemic volunteers, all non-smokers, without signs of cardiovascular disease and without biochemical signs of lipid metabolism disorders. The average age of the subjects was 21 years, and the control group involved 50 males and 100 females. Volunteers were recruited from medical students at the Medical Faculty, who gave written, informed consent, and the study was approved by the

A blood sample from an antecubital vein was obtained in the morning after a 12-hour fasting period. Total cholesterol and triglycerides in serum were analyzed from lipid parameters,

(International Society of Hypertension) on the management of hypertension [61].

individuals was examined and tested for the incidence of phenotype B.

**2. Arterial hypertension**

90 Lipoproteins - From Bench to Bedside

AH [35, 64].

**2.1. Patients**

was 51.0 ± 13.4 years.

local ethics committee.

**2.2. Methods**

In the control group shown in Table 2, along with the individuals with non-atherogenic normolipidemia, that is, an ideal lipoprotein profile (Fig. 1), a subgroup of normolipidemic individuals with an atherogenic lipoprotein profile was also identified. This group represented people with an atherogenic normolipidemia (Fig. 2). These people are clinically healthy, without clinical or laboratory signs of cardiovascular diseases, but with a positive familial history for cardiovascular diseases (myocardial infarction) in the parents' or grandparents' generation. The triglycerides and LDL3-7 concentrations in the control group with the atherogenic profile, compared to the individuals with a non-atherogenic lipoprotein profile, were increased (p < 0.05, respectively, p < 0.0001). The Score of the Anti-Atherogenic Risk (SAAR) for a non-atherogenic lipoprotein profile is a sensitive indicator by which to differen‐ tiate between an atherogenic and non-atherogenic plasma lipoprotein constellation (nonatherogenic vs. atherogenic: p < 0.0001).



Non-atherogenic profile, 93.4 % vs. atherogenic profile, 6.6 %, in control group

**Table 2.** Serum concentration of lipids, lipoproteins, and SAAR-score in the control group

\*Reference ranges derived from 125 serum samples that met the NCEP ATPIII guidelines for desirable lipid status \*\*LDL-C comprised of the sum of cholesterol in Md bands C through A as well as all the subfractions

**Figure 1.** Non-atherogenic normolipidemia – Control group, SAAR score: 62.5

The Assessment of the Atherogenic Lipoprotein Profile in Cardiovascular Diseases by Lipoprint System Analysis http://dx.doi.org/10.5772/60989 93

**Chol TAG VLDL LDL1, 2 LDL3-7 LDL HDL Score**

±0.60 ±0.39 ±0.16 ±0.37 ±0.004 ±0.52 ±0.32 ±18.5

**p<0.05 p< 0.0001 p< 0.0001**

**Control 4.27 1.17 0.61 1.28 0.04 2.30 1.34 35.8**

\*Reference ranges derived from 125 serum samples that met the NCEP ATPIII guidelines for desirable lipid status

\*\*LDL-C comprised of the sum of cholesterol in Md bands C through A as well as all the subfractions

**Figure 1.** Non-atherogenic normolipidemia – Control group, SAAR score: 62.5

Non-atherogenic profile, 93.4 % vs. atherogenic profile, 6.6 %, in control group

**Table 2.** Serum concentration of lipids, lipoproteins, and SAAR-score in the control group

(mmol/l±SD)

92 Lipoproteins - From Bench to Bedside

(atherogenic profile n = 10)

**(total number n=150)**

Non-atherogenic vs. atherogenic

\*Reference ranges derived from 125 serum samples that met the NCEP ATPIII guidelines for desirable lipid status \*\*LDL-C comprised of the sum of cholesterol in Md bands C through A as well as all the subfractions

**Figure 2.** Atherogenic normolipidemia – atherogenic subgroup of control group atherogenic small dense LDL are present in LDL 3,4 subfractions SAAR score: 2.7

A non-atherogenic lipoprotein profile in the control group was confirmed in 93.4% healthy normolipidemic individuals, and an atherogenic lipoprotein profile was found in 6.6%.

Table 3 shows high statistical significance for the analyzed lipid and lipoprotein parameters between the control group and the group of subjects with arterial hypertension (p < 0.0001, and for HDL, p <0.03).

In Table 4, 78.5% of patients with arterial hypertension have an atherogenic lipoprotein profile. There is a highly significantly increased concentration of small dense LDL (subfractions LDL3-7) in a subgroup of AH-patients, who have an atherogenic profile, compared to the concentration of small dense LDL in the subgroup of AH-patients with a non-atherogenic profile, which confirms the predominance of atherogenic lipoproteins in AH-patients and the creation of atherogenic lipoprotein profile, phenotype B, as well. SAAR in patients with AH is low, that is, 9.2 (cut off is 10.8), and confirms also the predominance of atherogenic lipopro‐ teins in serum.

\*Reference ranges derived from 125 serum samples that met the NCEP ATPIII guidelines for desirable lipid status \*\*LDL-C comprised of the sum of cholesterol in Md bands C through A as well as all the subfractions

**Figure 3.** Arterial hypertension with a borderline hypertriglyceridemia, small dense LDL are present in LDL3, 4 sub‐ fractions, SAAR score: 0.9


**Table 3.** Serum concentration of lipids, lipoproteins, and SAAR-score in AH patients vs.


Atherogenic 78.5% vs. non-atherogenic 21.5% – arterial hypertension

**Table 4.** Serum concentration of lipids, lipoproteins, and SAAR-score in patients with arterial hypertension
