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Homocysteine, adrenergic activity and left ventricular mass in patients with essential hypertension
Bozenna Wocial1, Hanna Berent, Maciej Kostrubiec
1Department of Internal Medicine and Hypertension, The Warsaw Medical University, Poland.
Insights
Essential hypertension (EH) is linked to higher homocysteine (Hcy) levels, increased left ventricular mass, and elevated adrenaline (A) and noradrenaline (NA) activity. These factors may increase cardiovascular disease risk in EH patients.
Area of Science:
- Cardiovascular Medicine
- Clinical Biochemistry
- Hypertension Research
Background:
- Essential hypertension (EH) is a significant risk factor for cardiovascular disease.
- Homocysteine (Hcy), noradrenaline (NA), and adrenaline (A) are implicated in cardiovascular health.
- Left ventricular mass index (LVMI) is a marker of cardiac remodeling in hypertension.
Purpose of the Study:
- To assess the relationship between homocysteine (Hcy) levels and noradrenaline (NA), adrenaline (A) concentrations, and left ventricular mass index (LVMI) in patients with essential hypertension (EH).
Main Methods:
- Study included 37 patients with mild EH and 37 healthy controls.
- Evaluated serum Hcy (ELISA), plasma NA and A (HPLC), and LVMI (echocardiography).
- Patients and controls were matched for age and sex.
Main Results:
- Patients with EH exhibited significantly higher Hcy levels (p < 0.01).
- Elevated NA and A levels were observed in the EH group (p < 0.05).
- EH patients had a significantly higher LVMI (p < 0.01), but no significant correlation was found between Hcy and other parameters.
Conclusions:
- High Hcy levels coexist with increased left ventricular mass and adrenergic activity in EH patients.
- The combination of high Hcy, left ventricular hypertrophy, and increased adrenergic activity may elevate the risk of atherosclerosis and cardiovascular disease in EH.
- Further research is warranted to explore the therapeutic implications of these findings.
Objective:
Assessment of relationship between homocysteine (Hcy) and noradrenaline (NA), adrenaline (A) concentration and left ventricular mass index (LVMI) in patients with essential hypertension (EH).
Design And Methods:
Samples obtained from 37 patients (14 female, 23 male) with mild EH (according to WHO criteria) (mean age 43.6 +/- 13.2 years) and 37 healthy volunteers (18 female, 19 male; mean age 38.2 +/- 10.6 years) were evaluated for Hcy (ELISA), NA and A (HPLC). Each patient underwent echocardiographic investigation with LVMI measurement (Penn convention). The examinations were performed in the outpatient clinic.
Results:
Hcy was significantly higher in patients with EH (8.7 +/- 2.4 vs 6.6 +/- 1.3 micromol/l; p < 0.01). NA and A levels were significantly elevated in the EH group (A: 43.9 +/- 26.4 vs 36.9 +/- 29.4 pg/ml; NA: 428.5 +/- 148.8 pg/ml vs 314.6 +/- 103.4 pg/ml; both p < 0.05). LVMI was also significantly higher in EH group (96.6 +/- 19.5 vs 83.4 +/- 16.0 g/m2; p < 0.01). There was no significant correlation between Hcy and other analysed parameters in the studied groups.
Conclusion:
High levels of Hcy appear together with increased left ventricular mass and augmented adrenergic activity in patients with EH. Coexistence of high Hcy concentration, left ventricular hypertrophy and increased adrenergic activity increases the risk of atherosclerosis and cardiovascular disease in patients with EH.