Chang-yi Wang1, Zhong-wei Chen2, Tao Zhang2, Jun Liu3, Si-han Chen2, Sheng-yuan Liu2, Li-yuan Han4, Zhao-hui Hui5, Yu-ming Chen6. 1. Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China; Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, People's Republic of China. 2. Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, People's Republic of China. 3. Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. 4. Department of Preventive Medicine, Medical School of Ningbo University, Ningbo, 315211, People's Republic of China. 5. Shenzhen Xili People's Hospital, Shenzhen, 518054, People's Republic of China. 6. Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. Electronic address: chenyum@mail.sysu.edu.cn.
Abstract
BACKGROUND: Accumulating data suggest that hyperhomocysteinemia is associated with the risk of ischemic stroke (IS) and coronary heart disease (CHD) in the general population, but the relationship remains unclear in hypertensive patients. We examined the association of total homocysteine (tHcy) with IS and CHD in hypertensive patients. METHODS: A total of 5935 Chinese hypertensive patients were recruited in a community-based cross-sectional study from 60 communities in Shenzhen, China. Plasma tHcy was quantitatively measured using the enzyme cycle method. Conventional risk factors for IS and CHD were obtained through questionnaire interviews and physical examinations. We included cerebral infarction, embolism and small-vessel disease as IS; and myocardial infarction, angina pectoris, coronary revascularization, and cardiac arrest as CHD. IS and CHD were retrospectively adjudicated by specialists via interviews, hospital records or relevant tests. RESULTS: Significantly higher values of tHcy were observed in IS patients than in non-IS controls among both men and women. Greater tHcy level was dose dependently associated with an increased risk of IS presence in women, men and them combined (p-trend: 0.002, 3.8×10(-4) and 0.001). The odds ratios (95% CI) of IS for tHcy ≥30 (vs. <15) μmol/L were 2.84 (1.73-4.34) in men, 4.41 (1.62-9.15) in women, and 2.86 (1.72-4.75) in their combination after adjusting for other main risk factors of IS. We did not find any significant association between tHcy and presence of CHD after the adjustment for covariates. CONCLUSIONS: Plasma homocysteine level is positively associated with the presence of IS, but not CHD, in Chinese hypertensive patients.
BACKGROUND: Accumulating data suggest that hyperhomocysteinemia is associated with the risk of ischemic stroke (IS) and coronary heart disease (CHD) in the general population, but the relationship remains unclear in hypertensivepatients. We examined the association of total homocysteine (tHcy) with IS and CHD in hypertensivepatients. METHODS: A total of 5935 Chinese hypertensivepatients were recruited in a community-based cross-sectional study from 60 communities in Shenzhen, China. Plasma tHcy was quantitatively measured using the enzyme cycle method. Conventional risk factors for IS and CHD were obtained through questionnaire interviews and physical examinations. We included cerebral infarction, embolism and small-vessel disease as IS; and myocardial infarction, angina pectoris, coronary revascularization, and cardiac arrest as CHD. IS and CHD were retrospectively adjudicated by specialists via interviews, hospital records or relevant tests. RESULTS: Significantly higher values of tHcy were observed in IS patients than in non-IS controls among both men and women. Greater tHcy level was dose dependently associated with an increased risk of IS presence in women, men and them combined (p-trend: 0.002, 3.8×10(-4) and 0.001). The odds ratios (95% CI) of IS for tHcy ≥30 (vs. <15) μmol/L were 2.84 (1.73-4.34) in men, 4.41 (1.62-9.15) in women, and 2.86 (1.72-4.75) in their combination after adjusting for other main risk factors of IS. We did not find any significant association between tHcy and presence of CHD after the adjustment for covariates. CONCLUSIONS: Plasma homocysteine level is positively associated with the presence of IS, but not CHD, in Chinese hypertensivepatients.