| Title: | High lipoprotein(a) and high BMI jointly confer the highest risk of ASCVD in both primary and secondary prevention |
| Journal: | European Journal of Preventive Cardiology |
| Published: | 23 Feb 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41725282/ |
| DOI: | https://doi.org/10.1093/eurjpc/zwag106 |
Publication 17658
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Abstract
AIMS: Novel pharmaceuticals lower body mass index (BMI) and reduce risk of atherosclerotic cardiovascular disease (ASCVD), yet treatment indications for BMI 27-30 kg/m² require additional risk factors. High lipoprotein(a), present in 1 in 5 individuals, is a risk factor for ASCVD not included in overweight treatment guidelines. We hypothesised that high lipoprotein(a) and BMI jointly confer the highest risk of ASCVD.</p>
METHODS: Prospective cohort study of 512,687 women and men without and 14,161 with ASCVD from the Copenhagen General Population Study (CGPS) and the UK Biobank. During follow-up, 39,255 and 3,501 developed ASCVD in primary and secondary prevention.</p>
RESULTS: In primary prevention, hazard ratios for ASCVD for individuals with high lipoprotein(a) (95th-100th percentile) and BMI>30 were 1.97 (95% CI:1.61-2.40) in the CGPS and 2.19 (2.01-2.37) in the UK Biobank when compared to low lipoprotein(a) (1st-49th percentile) and BMI of 18.5-26.9 kg/m². Absolute risks were higher for concomitant high lipoprotein(a) and BMI 27-30 kg/m² than for BMI>30 kg/m² and low lipoprotein(a), with 10-year absolute risks for ages 70-79 of 25% in women and 41% in men for lipoprotein(a) 95th-100th percentiles and BMI 27-30 kg/m², and correspondingly 17% and 28% for lipoprotein(a) 1st-49th percentiles and BMI>30 kg/m². In secondary prevention, overall results were similar, with higher risks for individuals with high lipoprotein(a) and BMI 18.5-26.9 kg/m², than for BMI≥27 kg/m2 and low lipoprotein(a).</p>
CONCLUSION: High lipoprotein(a) and high BMI jointly confer the highest risk of ASCVD in primary and secondary prevention.</p>
4 Authors
- Peter E Thomas
- Sune F Nielsen
- Børge G Nordestgaard
- Pia R Kamstrup
1 Application
| Application ID | Title |
|---|---|
| 104807 | Causal pathways of environmental and hereditary risk in common diseases: observational, metabolomic, and genetic studies |
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