Biochemical Characterisation of Apolipoprotein B and Lipoprotein(a) as Cardiovascular Risk Predictors Beyond Standard Lipid Panels in Hypertensive Patients in Kaduna State

Standard lipid panels may fail to capture the full atherogenic burden in hypertensive patients, and advanced lipoprotein biomarkers including apolipoprotein B and lipoprotein(a) provide cardiovascular risk information beyond traditional cholesterol measurements. This study biochemically characterises apolipoprotein B and lipoprotein(a) as cardiovascular risk predictors in hypertensive patients at Barau Dikko Teaching Hospital, Kaduna State. Two hundred hypertensive patients and one hundred normotensive age-matched controls were enrolled. Standard lipid profiles, apolipoprotein B by immunoturbidimetric assay, apolipoprotein A-I, lipoprotein(a) by immunoassay, and high-sensitivity CRP were determined from fasting blood samples. Carotid intima-media thickness was measured by duplex ultrasonography as a surrogate marker of subclinical atherosclerosis. The diagnostic performance of apolipoprotein B, lipoprotein(a), and non-HDL cholesterol was compared to standard LDL-C using receiver operating characteristic analysis against carotid intima-media thickness as the criterion reference. Apolipoprotein B was significantly elevated in hypertensive patients, and exceeded the atherogenic threshold of 100 mg/dL in 54 percent of hypertensive patients compared to 22 percent of controls. Lipoprotein(a) was elevated above 50 mg/dL in 29 percent of hypertensive patients, representing a heritable risk factor unaddressed by standard statin therapy. Apolipoprotein B demonstrated significantly higher AUC (0.84) for carotid intima-media thickness discrimination than LDL-C (0.72), indicating superior risk prediction. Non-HDL cholesterol performed intermediate to LDL-C and apolipoprotein B. The study recommends incorporating apolipoprotein B measurement into cardiovascular risk assessment for hypertensive patients in Kaduna State. Keywords: apolipoprotein B, lipoprotein(a), cardiovascular risk, hypertension, Kaduna State.