Elevated plasma homocysteine level is associated with ischemic stroke in Chinese hypertensive patients.
BACKGROUND
Accumulating data suggest that hyperhomocysteinemia is associated with the risk of ischemic stroke (IS) and coronary heart disease (CHD) in the general population, but the relationship remains unclear in hypertensive patients. We examined the association of total homocysteine (tHcy) with IS and CHD in hypertensive patients.


METHODS
A total of 5935 Chinese hypertensive patients were recruited in a community-based cross-sectional study from 60 communities in Shenzhen, China. Plasma tHcy was quantitatively measured using the enzyme cycle method. Conventional risk factors for IS and CHD were obtained through questionnaire interviews and physical examinations. We included cerebral infarction, embolism and small-vessel disease as IS; and myocardial infarction, angina pectoris, coronary revascularization, and cardiac arrest as CHD. IS and CHD were retrospectively adjudicated by specialists via interviews, hospital records or relevant tests.


RESULTS
Significantly higher values of tHcy were observed in IS patients than in non-IS controls among both men and women. Greater tHcy level was dose dependently associated with an increased risk of IS presence in women, men and them combined (p-trend: 0.002, 3.8×10(-4) and 0.001). The odds ratios (95% CI) of IS for tHcy ≥30 (vs. <15) μmol/L were 2.84 (1.73-4.34) in men, 4.41 (1.62-9.15) in women, and 2.86 (1.72-4.75) in their combination after adjusting for other main risk factors of IS. We did not find any significant association between tHcy and presence of CHD after the adjustment for covariates.


CONCLUSIONS
Plasma homocysteine level is positively associated with the presence of IS, but not CHD, in Chinese hypertensive patients.
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China; Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, People's Republic of China.
Chang-yi
CY
Wang
Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, People's Republic of China.
Zhong-wei
ZW
Chen
Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, People's Republic of China.
Tao
T
Zhang
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
Jun
J
Liu
Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, People's Republic of China.
Si-han
SH
Chen
Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, People's Republic of China.
Sheng-yuan
SY
Liu
Department of Preventive Medicine, Medical School of Ningbo University, Ningbo, 315211, People's Republic of China.
Li-yuan
LY
Han
Shenzhen Xili People's Hospital, Shenzhen, 518054, People's Republic of China.
Zhao-hui
ZH
Hui
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. Electronic address: chenyum@mail.sysu.edu.cn.
Yu-ming
YM
Chen
D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology; D002544:Cerebral Infarction / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D003327:Coronary Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*
Coronary heart disease; Homocysteine; Hypertension; Ischemic stroke