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Apo B is the major apolipoprotein of the atherogenic lipoproteins and has been suggested as an independent cardiovascular risk factor. The ratio between Apo B and Apo A1 has been used in large prospective studies as indicator of risk, but its wide implementation is not recommended for risk stratification. Left ventricular hypertrophy (LVH) and microalbuminuria, considered as target organ damage, have significant predictive value for future cardiovascular events. The aim of the present study was to investigate the association of ApoB/ApoA 1 ratio with LVH and microalbuminuria in never-treated hypertensive patients.

Design and method:

We studied 765 never treated hypertensive patients, free from overt cardiovascular disease. All patients were subject to transthoracic echocardiography and LVH was assessed by estimating left ventricular mass index (LVMI) using the Deveraux's formula. Albumin excretion was evaluated by immunonephelometry, after 24 h urine collection, and albumin to creatinine ratio (ACR) was calculated. Apo B and Apo A1 levels were measured in all participants and ApoB/ApoA 1 ratio was calculated.


In univariate analysis, ApoB/ApoA 1 ratio was significantly related to age, gender, smoking, systolic blood pressure (SBP), total cholesterol, fasting glucose, triglycerides, LVMI (r = 0.23, p < 0.001) and ACR (r = 0.31, p < 0.001). Performing multivariate regression analysis with LVMI and ACR as dependent variables, in two different models, after adjustment for age, gender, smoking, SBP, heart rate, glucose and total cholesterol, a strong independent relationship was established between both LVMI and ACR with ApoB/ApoA 1 ratio (b = 0.12, p = 0.03 and b = 0.17, p < 0.001, respectively).


ApoB/ApoA 1 ratio is independently related to target organ damage in never treated hypertensive patients. Considering the adverse predictive role of LVH and microalbuminuria in hypertensive population, it might be suggested that ApoB/ApoA 1 ratio may be used as a useful marker for indentifying patients at high risk. Future studies need to clarify whether treatment of an increased ApoB/Apo A 1 ratio may benefit hypertensive patients with target organ damage.

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