Elevated Homocysteine Concentrations Decrease the Antihypertensive Effect of Angiotensin-Converting Enzyme Inhibitors in Hypertensive Patients.
We aimed to examine whether baseline homocysteine (Hcy) concentrations affect antihypertensive responses to enalapril treatment among previously untreated hypertensive patients (n=10 783) in the CSPPT (China Stroke Primary Prevention Trial).



After a 3-week run-in treatment with a daily dose of 10 mg enalapril, eligible hypertensive patients were randomly assigned to a double-blind daily treatment of a tablet of either enalapril (10 mg) and folic acid (0.8 mg) or enalapril (10 mg) alone for a median of 4.5 years. After the 3-week treatment period with enalapril alone, the systolic blood pressure-lowering effect was significantly reduced by 1.39 (95% confidence interval 0.40-2.37) and 3.25 (95% confidence interval 1.98-4.52) mm Hg, respectively, in those with baseline Hcy concentrations of 10 to 15 and ≥15 μmol/L (P for trend <0.001) as compared with those with Hcy concentration of <10 μmol/L. Similar results were observed after a 15-week treatment period with enalapril alone. After a median 4.5-year enalapril-based antihypertensive treatment period, compared with those with Hcy concentration of <10 μmol/L, the systolic blood pressure-lowering effect was still significantly reduced by 0.77 (95% confidence interval 0.01-1.53) and 1.70 (95% confidence interval 0.72-2.68) mm Hg, respectively, in those with Hcy concentrations of 10 to 15 and ≥15 μmol/L (P for trend <0.001). In addition, participants with higher baseline Hcy concentrations had persistently higher systolic blood pressure levels across the entire study treatment period. Similarly, baseline Hcy concentrations were inversely associated with diastolic blood pressure reduction during the short-term enalapril alone treatment. However, the inverse association between baseline Hcy and diastolic blood pressure reduction was attenuated and became insignificant after the long-term enalapril-based treatment period.



Elevated Hcy concentrations significantly decreased the antihypertensive effect of the short-term and long-term enalapril-based antihypertensive treatment in previously untreated hypertensive patients.
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Xianhui
X
Qin
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Youbao
Y
Li
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Ningling
N
Sun
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Hong
H
Wang
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Yan
Y
Zhang
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Jiguang
J
Wang
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Jianping
J
Li
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Xin
X
Xu
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Min
M
Liang
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Jing
J
Nie
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Binyan
B
Wang
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Xiaoshu
X
Cheng
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Nanfang
N
Li
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Yingxian
Y
Sun
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Lianyou
L
Zhao
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Xiaobin
X
Wang
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.).
Fan Fan
FF
Hou
From the Renal Division, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China (X.Q., Y.L., X.X., M.L., J.N., B.W., F.F.H.); Department of Cardiology, Peking University People's Hospital, Beijing, China (N.S.); Centers for Metabolic Disease Research, Temple University School of Medicine, PA (H.W.); Department of Cardiology, Peking University First Hospital, Beijing, China (Y.Z., J.L., Y.H.); Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (J.W.); Department of Cardiology, Second Affiliated Hospital, Nanchang University, China (X.C.); Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, the Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Urumqi, China (N.L.); Department of Cardiovascular Medicine, the First Hospital of China Medical University, Shenyang, China (Y.S.); Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China (L.Z.); and Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (X.W.). huoyong@263.net.cn ffhouguangzhou@163.com.
Yong
Y
Huo
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects*; D002681:China; D004311:Double-Blind Method; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D015415:Biomarkers; D006710:Homocysteine; D004656:Enalapril; D005492:Folic Acid
antihypertensive responses; enalapril-based antihypertensive treatment; folic acid therapy; homocysteine concentrations; hypertension