Department of Cardiology, Tianjin Medical University General Hospital , Tianjin , People's Republic of China.
Clin Exp Hypertens. 2015;37(3):218-22. doi: 10.3109/10641963.2014.939276. Epub 2014 Jul 22.
Study suggested that elevated homocysteine showed a multiplicative effect on cardiovascular diseases in hypertensive subjects. It was reported that elevated homocysteine level was independently associated with increased arterial stiffness in prehypertensives. It remains unclear whether prehypertensives combined with elevated homocysteine have adverse cardiovascular risk factors. We aimed to compare cardiometabolic risk profile between prehypertensives with hyperhomocysteinaemia and those without either condition.
Plasma total homocysteine and risk profile were determined among 874 Chinese non-hypertension individuals in Tianjin. They were subdivided into four groups: prehypertension with hyperhomocysteinaemia (≥10 μmol/L), prehypertension with normal homocysteine (<10 μmol/L), normotension with hyperhomocysteinaemia, normotension with normol homocysteine, respectively.
In 874 participants, 22.5% of them were male, mean age was 56.8 years. In multiple comparisons, after adjustment for age, gender, smoking, alcohol, exercise, education prehypertensives had higher body mass index (BMI) and high sensitive C reactive protein (hs-CRP) than normotensives (p < 0.05, respectively); Only prehypertensive subjects with hyperhomocysteinaemia had higher triglyceride and serum uric acid compared to normotensive subjects, and lower HDL cholesterol than normotensives with normal homocysteine (p < 0.05, respectively). However, the significance of higher hs-CRP, uric acid and lower HDL cholesterol were abolished when further adjustment was made for BMI.
The combination of prehypertension and hyperhomocusteinaemia increases the likelihood of having adverse cardiometabolic risk profile. Strict lipid management and weigh control may be needed in prehypertensives with elevated homocysteine.
研究表明,高同型半胱氨酸水平在高血压患者中对心血管疾病具有倍增效应。有报道称,高同型半胱氨酸水平与前期高血压患者动脉僵硬程度增加独立相关。目前尚不清楚前期高血压合并高同型半胱氨酸血症是否具有不良心血管危险因素。我们旨在比较高同型半胱氨酸血症前期高血压患者和无上述两种情况的患者的心血管代谢风险特征。
在天津的 874 名非高血压个体中测定血浆总同型半胱氨酸和风险特征。他们被分为四组:高同型半胱氨酸血症前期高血压(≥10μmol/L)、正常同型半胱氨酸血症前期高血压(<10μmol/L)、高同型半胱氨酸血症正常血压、正常同型半胱氨酸血症正常血压。
在 874 名参与者中,22.5%为男性,平均年龄为 56.8 岁。在多重比较中,调整年龄、性别、吸烟、饮酒、运动、教育等因素后,前期高血压患者的体重指数(BMI)和高敏 C 反应蛋白(hs-CRP)高于正常血压患者(p<0.05);只有高同型半胱氨酸血症前期高血压患者的甘油三酯和血尿酸高于正常血压患者,而高密度脂蛋白胆固醇低于正常同型半胱氨酸血症的正常血压患者(p<0.05)。然而,当进一步调整 BMI 后,hs-CRP 升高、尿酸升高和 HDL 胆固醇降低的意义消失。
前期高血压和高同型半胱氨酸血症的联合增加了不良心血管代谢风险特征的可能性。需要对高同型半胱氨酸血症的前期高血压患者进行严格的血脂管理和体重控制。