Abstract
Objective
Hyperhomocysteinemia (HHcy) and hypertension are associated with cardiovascular events. However, effects of Hcy-lowing interventions on cardiovascular outcome were conflicting. Serum folate level was proposed to be a possible determinant of efficacy of extra folate supplementation on cardiovascular outcome. The aims of the present study were to describe representative information on the levels of serum homocysteine and folate in hypertensive patients, and to explore the major determinants of HHcy.
Methods
11,007 participants with hypertension were analyzed in this cross-sectional study. Blood pressure and serum levels of biochemical indicators were measured. Multivariate logistic regression model was used to assess the associated factors of HHcy.
Results
Geometric mean of serum total homocysteine was 14.1 (95% CI: 13.9, 14.4) μmol/L and prevalence of HHcy was 36.1 (95% CI: 34.0, 38.1) % in hypertensive patients. HHcy was strongly associated with factors including male sex, older age, elevated serum creatinine (SCr), lower serum folate and vitamin B12, and uncontrolled blood pressure in hypertensive patients. Elevated SCr attributed to HHcy with the etiologic fraction of 0.29. The change of the odds ratio of HHcy associated with folate was significantly higher in patients with elevated SCr compared with that of patients with normal SCr.
Conclusion
The results suggested the protection of female sex and higher levels of folate and vitamin B12 from HHcy and attribution of older age and elevated SCr to HHcy. Restoring renal function deserved attention for hypertensive patients to benefit from Hcy-lowing measures.
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Data availability
Data will be available from the corresponding author upon request.
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Acknowledgements
This work was supported by Shanghai Municipal Commission of Health and Family Planning grant 20134129, Shanghai Municipal Health Commission (GWV-7, GWV-10.1-XK05, and GWV-10.1-XK16), and the funding of Innovative research team of high-level local universities in Shanghai and a key laboratory program of the Education Commission of Shanghai Municipality (ZDSYS14005). Shanghai Municipal Center for Disease Control and Prevention also facilitated this research. We greatly appreciate the support of the District Health and Family Planning Commission and the district centers of Disease Control and Prevention.
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MC designed the study. MC and HX wrote the manuscript. XL and QY did the data analysis and interpretation. DZ and YW provided suggestions to the study. YS and CF supervised the study and revised the manuscript.
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Cheng, M., Xue, H., Li, X. et al. Prevalence of hyperhomocysteinemia (HHcy) and its major determinants among hypertensive patients over 35 years of age. Eur J Clin Nutr 76, 616–623 (2022). https://doi.org/10.1038/s41430-021-00983-6
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DOI: https://doi.org/10.1038/s41430-021-00983-6
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