Department of Cardiology, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, QingPu District Central Hospital Shanghai, Shanghai, China.
Department of Cardiology, QingPu District Jinze Community Health Center, Shanghai, China.
BMC Cardiovasc Disord. 2021 Aug 4;21(1):376. doi: 10.1186/s12872-021-02151-x.
H type hypertension is defined as homocysteine (Hcy) ≥ 10 μmol/L in combination with primary hypertension. Studies demonstrated that the existence of hyperhomocysteine (HHcy) in hypertensive exacerbates the poor outcome of cardiocerebral incidents. This study was to investigate the current epidemic situation of H type hypertension and determine the risk factors in order to find intervention targets for H type hypertensives.
We conducted a cross-sectional study using cluster sampling design in Shanghai, China from July 2019 and April 2020. 23,652 patients with primary hypertension were enrolled in this study. Their medical information was recorded, and the level of Hcy concentrations and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms were detected.
In total, 22,731 of 23,652 patients were recorded. The mean age was 68.9 ± 8.6 y and 43% were men. 80.0% of the enrolled patients had H type hypertension. The frequency of allele T was 40.9%, and the proportions of the CC, CT, and TT genotypes were 36.1%, 46.0%, and 17.9%, respectively. Compared with the TT genotype, the plasma Hcy concentration levels were lower in patients with the CC/CT genotype (18.96 ± 13.48 μmol/L vs. 13.62 ± 5.20/14.28 ± 5.36, F = 75.04, p < 0.01). The risk for H type hypertension was higher in elderly people. Men had ~ 5.55-fold odds of H type hypertension compared with women. Patients with CT genotype and TT genotype had ~ 1.36- and ~ 2.76-fold odds of H type hypertension compared with those with CC genotype, respectively. Smoking and diabetes were not significantly associated with H type hypertension.
The prevalence of H type hypertension in patients with primary hypertension was 80.0%, which was higher than the 75% found in prior report in China. Age, gender, and MTHFR C677T polymorphisms rather than smoking and diabetes were independently associated with H type hypertension.
H 型高血压定义为同型半胱氨酸（Hcy）≥10 μmol/L 并伴有原发性高血压。研究表明，高血压患者中高同型半胱氨酸（HHcy）的存在会加剧心脑血管事件的不良预后。本研究旨在调查 H 型高血压的当前流行情况，并确定危险因素，以便为 H 型高血压患者找到干预靶点。
我们采用整群抽样设计，于 2019 年 7 月至 2020 年 4 月在中国上海进行了一项横断面研究。共纳入 23652 例原发性高血压患者，记录其一般资料，检测 Hcy 浓度和亚甲基四氢叶酸还原酶（MTHFR）C677T 多态性。
共记录了 22731 例 23652 例患者的资料。患者的平均年龄为 68.9±8.6 岁，其中 43%为男性。80.0%的患者患有 H 型高血压。等位基因 T 的频率为 40.9%，CC、CT 和 TT 基因型的比例分别为 36.1%、46.0%和 17.9%。与 TT 基因型相比，CC/CT 基因型患者的血浆 Hcy 浓度水平较低（18.96±13.48 μmol/L 比 13.62±5.20/14.28±5.36，F=75.04，p<0.01）。老年人发生 H 型高血压的风险更高。与女性相比，男性发生 H 型高血压的风险约为女性的 5.55 倍。与 CC 基因型相比，CT 基因型和 TT 基因型患者发生 H 型高血压的风险分别约为 1.36 倍和 2.76 倍。吸烟和糖尿病与 H 型高血压无显著相关性。
原发性高血压患者 H 型高血压的患病率为 80.0%，高于中国既往报道的 75%。年龄、性别和 MTHFR C677T 多态性而非吸烟和糖尿病与 H 型高血压独立相关。
