Affiliation:
1. From the Department of Epidemiology (K.S.-T., C.Z.-J.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pa; and the Vitamin Bioavailability Laboratory (A.B., J.S.), Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts New England Medical Center, Boston, Mass.
Abstract
Background
The association between homocysteine and isolated systolic hypertension in older adults was evaluated using a case-control design, and the relationship between homocysteine and clinical or subclinical atherosclerosis was explored.
Methods and Results
Cases were 179 adults ≥60 years with a systolic blood pressure of ≥160 mm Hg and diastolic blood pressure <90 mm Hg. One hundred seventy-one control subjects had the same criteria except systolic blood pressures were <160 mm Hg. All had normal creatinine levels. Homocysteine levels were performed on fasting blood samples that had been stored at −70°C. Atherosclerosis was defined as either a history of clinical disease, an internal carotid stenosis of ≥40% by duplex scan, or an ankle/arm pressure ratio of <0.9. The median homocysteine value was 11.5 μmol/L for cases and 9.9 for control subjects (
P
<.001). After control for potential confounders, homocysteine remained significantly associated with systolic hypertension (
P
=.019). For the hypertensive group, there was no apparent association between level of homocysteine and prevalence of atherosclerosis. However, among the normotensive group, the prevalence of atherosclerosis went from 22% in the lowest quintile of homocysteine values to 53% in the fifth quintile, with an odds ratio of 4.1 (fifth quintile in comparison to the first,
P
<.05). After adjustment for age, sex, systolic blood pressure, cholesterol, and smoking, this odds ratio increased to 6.4 (
P
<.01).
Conclusions
Elevated levels of homocysteine may be related to the cause of isolated systolic hypertension in some individuals. In normotensive older adults, homocysteine appears to be an independent risk factor for atherosclerosis.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Cited by
237 articles.
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