title: Nonfasting plasma total homocysteine levels and stroke incidence in elderly persons: the Framingham Study.
abstract: BACKGROUND
  Total homocysteine levels are associated with arteriosclerotic outcomes.
  
  
  OBJECTIVE
  To determine whether total homocysteine levels predict incident stroke in elderly persons.
  
  
  METHODS
  Prospective population-based cohort study with 9.9 years of follow-up.
  
  
  METHODS
  Framingham, Massachusetts.
  
  
  METHODS
  1947 Framingham Study participants (1158 women and 789 men; mean age +/- SD, 70 +/- 7 years).
  
  
  METHODS
  Baseline total homocysteine levels and 9.9-year stroke incidence.
  
  
  RESULTS
  The quartiles of nonfasting total homocysteine levels were as follows: quartile 1, 4.13 to 9.25 micromol/L; quartile 2, 9.26 to 11.43 micromol/L; quartile 3, 11.44 to 14.23 micromol/L; quartile 4, 14.24 to 219.84 micromol/L. During follow-up, 165 incident strokes occurred. In proportional hazards models adjusted for age, sex, systolic blood pressure, diabetes, smoking, and history of atrial fibrillation and coronary heart disease, relative risk (RR) estimates comparing quartile 1 with the other three quartiles were as follows: quartile 2 compared with quartile 1--RR, 1.32 (95% CI, 0.81 to 2.14); quartile 3 compared with quartile 1--RR, 1.44 (CI, 0.89 to 2.34); quartile 4 compared with quartile 1--RR, 1.82 (CI, 1.14 to 2.91). The linear trend across the quartiles was significant (P < 0.001).
  
  
  CONCLUSIONS
  Nonfasting total homocysteine levels are an independent risk factor for incident stroke in elderly persons.
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts 02111, USA.
authors.forename: A G
authors.initials: AG
authors.lastname: Bostom
authors.forename: I H
authors.initials: IH
authors.lastname: Rosenberg
authors.forename: H
authors.initials: H
authors.lastname: Silbershatz
authors.forename: P F
authors.initials: PF
authors.lastname: Jacques
authors.forename: J
authors.initials: J
authors.lastname: Selhub
authors.forename: R B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: P W
authors.initials: PW
authors.lastname: Wilson
authors.forename: P A
authors.initials: PA
authors.lastname: Wolf
mesh_terms: D000368:Aged; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors
chemical_list: D006710:Homocysteine