Associations among oxidative stress, Lp-PLA₂ activity and arterial stiffness according to blood pressure status at a 3.5-year follow-up in subjects with prehypertension

Background and aims We aimed to determine changes in oxidative stress, lipoprotein-associated phospholipase A₂ (Lp-PLA₂) activity and arterial stiffness in subjects with persistent prehypertensive symptoms during a 3.5-year follow-up period. Methods We divided 254 subjects with prehypertension according to their blood pressure (BP) status at 3.5 years of follow-up into three groups: reversed normotensive, persistent prehypertensive and developed hypertensive group. BP, serum lipid profile, oxidized LDL (ox-LDL), Lp-PLA₂ activity and brachial-ankle pulse wave velocity (ba-PWV) were measured at baseline and the 3.5-year follow-up. Results The reversed normotensive group showed a significant reduction in average BP (14.7/10.1 mmHg), whereas the developed hypertensive group showed a significant increase in average BP (15.2/11.5 mmHg). The persistent prehypertensive group showed increases in serum lipid profiles, circulating levels of Lp-PLA₂ activity, ox-LDL and arterial stiffness as measured by ba-PWV at 3.5 years. The persistent prehypertensive and developed hypertensive groups showed greater increases in ox-LDL than the reversed normotensive group. The developed hypertensive group showed greater increases in Lp-PLA₂, 8-epi-PGF_2α, and ba-PWV than those observed in the reversed normotensive and persistent prehypertensive groups. In all subjects, changes (Δ) in systolic blood pressure (SBP) positively correlated with Δ Lp-PLA₂, Δ ox-LDL, Δ urinary 8-epi-PGF_2α and Δ ba-PWV. Conclusions This study indicates that in persistent prehypertension, increased ox-LDL hydrolysis by Lp-PLA₂ enhances arterial stiffness without an age-related increase in BP.