Homocysteine and ischaemic stroke in men: the Caerphilly study.
OBJECTIVE
To assess the risk of ischaemic stroke associated with total serum homocyst(e)ine (tHcy) concentration.


METHODS
Cohort study.


METHODS
Caerphilly, South Wales


METHODS
2254 men age 50 to 64 years recruited between 1984 and 1988.


RESULTS
107 men developed ischaemic stroke and mean follow up time was 10.2 years. There was no significant difference in mean serum total homocyst(e)ine levels between stroke cases (12.2 micromol 95% CI 11.6 to 13.1) and non-cases (11.7 micromol 95% CI 11.5 to 11.9) (p=0.14). There was no significant risk for a standard deviation increase in homocyst(e)ine (adjusted hazard ratio = 1.1, 95% CI 0.9 to 1.4). An interaction was observed between homocyst(e)ine and age at entry (p=0.003). The adjusted odds ratio comparing the top quintile of homocyst(e)ine with the rest was 2.5 (95% CI 1.0 to 6.2) for strokes occurring under 65 years and 0.5 (95% CI 0.2 to 1.3) at 65 years or older (p value for interaction =0.02). Risk also differed by blood pressure status. The adjusted hazard ratio for a standard deviation increase in homocyst(e)ine was 0.8, (95% CI 0.6 to 1.2) for normotensive men and 1.3 (95% CI 1.1 to 1.7) for hypertensive men (p value for interaction =0.01).


CONCLUSIONS
Overall, there is no significant relation between homocyst(e)ine and ischaemic stroke in this cohort. However, its aetiological importance may be greater for premature ischaemic strokes (<65 years) and in hypertensive men.
Fallon
U B
UB
Department of Social Medicine, University of Bristol, Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK. una.fallon@bristol.ac.uk
Elwood
P
P
Ben-Shlomo
Y
Y
Ubbink
J B
JB
Greenwood
R
R
Smith
G D
GD
D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D014852:Wales / Q000453:epidemiology
D015415:Biomarkers; D006710:Homocysteine