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Circulating homocysteine levels in sustained and white coat hypertension
S D Pierdomenico1, A Bucci, D Lapenna
1Centro per lo Studio dell'Ipertensione Arteriosa, delle Dislipidemie e dell'Arteriosclerosi, Dipartimento di Medicina e Scienze dell'Invecchiamento, University Gabriele d'Annuzio, Chieti, Italy. pierdomenico@unich.it
Insights
White coat hypertension patients have lower homocysteine levels than sustained hypertension patients. This suggests white coat hypertension may indicate a lower cardiovascular risk in individuals without other risk factors.
Area of Science:
- Cardiology
- Clinical Biochemistry
Background:
- White coat hypertension (WCH) is a condition where blood pressure is elevated in a clinical setting but normal outside of it.
- The cardiovascular risk profile associated with WCH requires further clarification.
- Homocysteine is an emerging biomarker for cardiovascular risk.
Purpose of the Study:
- To investigate circulating homocysteine levels in individuals with WCH compared to sustained hypertension (SH) and normotensive controls.
- To assess the association between WCH and homocysteine as a potential cardiovascular risk factor.
Main Methods:
- A comparative study involving 31 SH patients, 31 WCH patients, and 31 normotensive controls matched for age, gender, BMI, and occupation.
- Exclusion of participants with smoking habits, dyslipidemia, or diabetes mellitus.
- Measurement of fasting homocysteine levels using fluorescence polarization immunoassay.
Main Results:
- No significant differences in creatinine, glucose, cholesterol, or triglycerides among the groups.
- Significantly lower homocysteine levels in WCH subjects compared to SH patients (8.2±2.0 vs 12.6±3.9 µmol/l, P=0.0003).
- No significant difference in homocysteine levels between WCH subjects and normotensive controls (8.2±2.0 vs 7.6±1.9 µmol/l, P=0.9).
Conclusions:
- Middle-aged individuals with WCH and no other cardiovascular risk factors exhibit lower circulating homocysteine levels than those with SH.
- These findings suggest that WCH may be associated with a reduced cardiovascular risk profile compared to SH.
Abstract:
Although white coat hypertension has been widely studied in the last years, its risk profile is not yet completely clear. The aim of this study was to evaluate circulating homocysteine levels, an emerging cardiovascular risk factor, in subjects with white coat and sustained hypertension. We selected 31 sustained hypertensive subjects, 31 white coat hypertensive subjects and 31 normotensive subjects matched for age, gender, body mass index and occupation. Women were also matched for menopausal status. Subjects with smoking habit, dyslipidaemia and diabetes mellitus were excluded from the study. White coat hypertension was defined as clinical hypertension and daytime ambulatory blood pressure <135/85 mmHg. Blood samples were drawn after a fasting period of 12 h for routine laboratory tests and homocysteine determination. Homocysteine levels were evaluated by fluorescence polarization immunoassay. Creatinine, glucose, cholesterol and triglycerides were not different among the groups. White coat hypertensive subjects had significantly lower homocysteine levels than sustained hypertensive patients (8.2+/-2.0 vs 12.6+/-3.9 micromol/l, P=0.0003). No significant difference was observed between white coat hypertensive and normotensive subjects regarding this parameter (8.2+/-2.0 vs 7.6+/-1.9 micromol/l, P=0.9). In conclusion, our data show that middle-aged white coat hypertensive subjects without other cardiovascular risk factors have lower circulating homocysteine levels than sustained hypertensive patients suggesting that they are at lower cardiovascular risk.