title: Association between homocysteine and incidence of ischemic stroke in subjects with essential hypertension: a matched case-control study.
abstract: BACKGROUND
  To assess the association between total plasma homocysteine (tHcy) and ischemic stroke (IS) in hypertensive subjects in a matched case-control study.
  
  
  METHODS
  This is a 1:2 matched and population-based case-control study, all of the participants were recruited from the 60 communities in Shenzhen, China. Demographic and socioeconomic characteristics, medical records, lifestyle risk factors and other clinical characteristics were obtained from all of the subjects. The association between tHcy and incidence of IS was analyzed by using conditional logistic regression models.
  
  
  RESULTS
  The median values of plasma tHcy were significantly higher in IS subjects than in non-IS subjects, especially in women. After adjusted for the confounding factors in Model 2, compared with the lowest quartile of tHcy, the odds ratios (ORs) and 95% CIs of the highest quartile of tHcy for IS were 0.83 (0.36-1.90) in men, 4.51 (1.29-15.7) in women and 1.31 (0.70-2.47) in the total subjects; the ORs and 95% CIs for IS per 5 μmol/L increase in homocysteine were 1.11 (0.99-1.22), 1.25 (1.03-1.58) and 1.15 (1.01-1.28) in men, women and total subjects, respectively. We observed significant associations in crude model, Model 1 and Model 2 in women for the comparison of tHcy ≥ 15 μmol/L versus < 15 μmol/L. Interaction analysis showed that the association of tHcy with IS was significant in women (p-interaction = 0.04).
  
  
  CONCLUSIONS
  This matched case-control study indicates that tHcy may increase the susceptibility to IS in essential hypertension subjects, especially in women. Further large prospective cohort studies are needed to confirm our findings.
authors.affiliation: a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China .
authors.forename: Changyi
authors.initials: C
authors.lastname: Wang
authors.affiliation: b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China .
authors.forename: Liyuan
authors.initials: L
authors.lastname: Han
authors.affiliation: c Department of Social Medicine , School of Public Health, Harbin Medical University , Harbin , Heilongjiang Province , People's Republic of China , and.
authors.forename: Qunhong
authors.initials: Q
authors.lastname: Wu
authors.affiliation: b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China .
authors.forename: Renjie
authors.initials: R
authors.lastname: Zhuo
authors.affiliation: d Department of Science Research and Information Management , Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou , China.
authors.forename: Kui
authors.initials: K
authors.lastname: Liu
authors.affiliation: b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China .
authors.forename: Jinshun
authors.initials: J
authors.lastname: Zhao
authors.affiliation: b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China .
authors.forename: Lina
authors.initials: L
authors.lastname: Zhang
authors.affiliation: c Department of Social Medicine , School of Public Health, Harbin Medical University , Harbin , Heilongjiang Province , People's Republic of China , and.
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Hao
authors.affiliation: b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China .
authors.forename: Rui
authors.initials: R
authors.lastname: Fan
authors.affiliation: b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China .
authors.forename: Yanfen
authors.initials: Y
authors.lastname: Liu
authors.affiliation: b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China .
authors.forename: Runhua
authors.initials: R
authors.lastname: Li
authors.affiliation: a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China .
authors.forename: Zhongwei
authors.initials: Z
authors.lastname: Chen
authors.affiliation: a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China .
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China .
authors.forename: Sihan
authors.initials: S
authors.lastname: Chen
authors.affiliation: a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China .
authors.forename: Jianping
authors.initials: J
authors.lastname: Ma
authors.affiliation: a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China .
authors.forename: Shengyuan
authors.initials: S
authors.lastname: Liu
authors.affiliation: a Department of Chronic Disease Prevention and Control , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen , People's Republic of China .
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Peng
authors.affiliation: b Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology , Medical School of Ningbo University , Ningbo , People's Republic of China .
authors.forename: Shiwei
authors.initials: S
authors.lastname: Duan
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000097:blood*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D000075222:Essential Hypertension; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology / Q000209:etiology
chemical_list: D006710:Homocysteine
keywords: Association study, case-control study, essential hypertension, homocysteine, ischemic stroke