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Homocysteine and ischaemic stroke in men: the Caerphilly study
U B Fallon1, P Elwood, Y Ben-Shlomo
1Department of Social Medicine, University of Bristol, Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK. una.fallon@bristol.ac.uk
Journal of Epidemiology and Community Health
|January 12, 2001
Summary
High homocysteine levels do not generally increase ischemic stroke risk. However, elevated homocysteine may pose a greater risk for premature strokes and in men with hypertension.
Area of Science:
- Cardiovascular Epidemiology
- Neurology
- Clinical Biochemistry
Background:
- Elevated total serum homocysteine (tHcy) has been investigated as a potential risk factor for ischemic stroke.
- Previous studies suggest a possible link, but findings have been inconsistent.
Purpose of the Study:
- To evaluate the association between total serum homocysteine (tHcy) concentration and the risk of developing ischemic stroke.
- To explore potential interactions between tHcy, age, and blood pressure in relation to stroke risk.
Main Methods:
- A cohort study involving 2254 men aged 50-64 years.
- Participants were recruited between 1984 and 1988 in Caerphilly, South Wales.
- Follow-up averaged 10.2 years, during which 107 ischemic strokes occurred.
Main Results:
- No significant difference in mean tHcy levels was found between stroke cases and non-cases.
- Overall, no significant increased risk of ischemic stroke was associated with higher tHcy levels.
- A significant interaction was observed between tHcy and age, with higher risk in younger men (<65 years).
- Risk also differed by blood pressure status, with a higher risk in hypertensive men.
Conclusions:
- Overall, total serum homocysteine concentration is not significantly related to ischemic stroke risk in this cohort.
- However, tHcy may play a more significant etiological role in premature ischemic strokes and in hypertensive individuals.