title: Homocysteine levels and risk of essential hypertension: A meta-analysis of published epidemiological studies.
abstract: BACKGROUND
  Plasma homocysteine (Hcy) levels may be associated with essential hypertension (EH). However, the results of previous studies on this association are inconsistent.
  
  
  METHODS
  In this meta-analysis, we performed a systematic literature search of the Embase, PubMed, Cochrane Library, and Web of Science for the relevant articles dated up to March 2016. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to evaluate the estimates.
  
  
  RESULTS
  We included 11 studies with a total of 16,571 participants (4,830 EH cases). We found that elevated Hcy levels were associated with the risk of EH (pooled OR: 1.36, 95% CI: 1.02-1.80 in the random-effects model). However, subsequent subgroup analyses showed that elevated Hcy levels increased the EH risk in retrospective studies (OR: 1.82, 95% CI: 1.53-2.16; p < 0.001) and unadjusted studies (OR: 1.72, 95% CI: 1.43-2.07; p < 0.001), but not in perspective studies (OR: 0.99, 95% CI: 0.73-1.28; p = 0.939) and adjusted studies (OR: 1.21, 95% CI: 0.85-1.72; p = 0.297). No significant publication bias was found (p = 0.876 for Begg's test, p = 0.144 for Egger's test).
  
  
  CONCLUSIONS
  Plasma Hcy levels are associated with EH risk. However, our findings do not support a causal association between Hcy levels and EH.
authors.affiliation: a Ningbo Municipal Blood Center , Ningbo , Zhejiang , China.
authors.forename: Fade
authors.initials: F
authors.lastname: Zhong
authors.affiliation: a Ningbo Municipal Blood Center , Ningbo , Zhejiang , China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhuang
authors.affiliation: b Ningbo Municipal Medical Center Eastern Lihuili Hospital , Ningbo , Zhejiang , China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: c Ningbo Municipal Medical Center Lihuili Hospital , Ningbo , Zhejiang , China.
authors.forename: Youli
authors.initials: Y
authors.lastname: Ma
mesh_terms: D000075222:Essential Hypertension; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000453:epidemiology*; D006973:Hypertension / Q000097:blood / Q000453:epidemiology*; D016017:Odds Ratio; D017594:Publication Bias; D012307:Risk Factors
chemical_list: D006710:Homocysteine
keywords: Epidemiological study; essential hypertension; homocysteine; meta-analysis; odds ratio