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Further evidence of interrelation between homocysteine and hypertension in stroke patients: a cross-sectional study

Eliyahu H Mizrahi1, Shlomo Noy, Ben-Ami Sela

  • 1Department of Geriatric Medicine, Sheba Medical Center, Tel Hashomer, Israel. exm42@sheba.health.gov.il

The Israel Medical Association Journal : IMAJ
|December 3, 2003
PubMed

Insights

High total plasma homocysteine (tHcy) levels are linked to increased risk of recurrent stroke and hypertension in acute ischemic stroke patients. Identifying these patients is crucial for effective secondary prevention strategies.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Clinical Chemistry

Background:

  • Elevated total plasma homocysteine (tHcy) is a known risk factor for cardiovascular and cerebrovascular diseases.
  • Existing evidence on the association between plasma tHcy levels and hypertension is inconsistent.

Purpose of the Study:

  • To investigate the relationship between plasma tHcy levels and common cerebrovascular disease risk factors.
  • Specifically examined associations with recurrent stroke, diabetes mellitus, hypertension, ischemic heart disease, and hyperlipidemia in acute ischemic stroke patients.

Main Methods:

  • Retrospective cross-sectional chart analysis of 113 acute ischemic stroke patients.
  • Plasma tHcy levels measured using high-performance liquid chromatography with fluorescence detection.
  • Multivariate logistic regression used to assess independent relationships between risk factors and tHcy levels above the 75th percentile.

Main Results:

  • Hypertension was significantly more prevalent in patients with plasma tHcy levels above the 75th percentile (80.8% vs. 51.7%, P = 0.012).
  • High plasma tHcy levels were independently associated with a 3.4-fold increased odds of recurrent stroke (P = 0.037) and a 4.02-fold increased odds of hypertension (P = 0.028).

Conclusions:

  • High plasma tHcy levels are significantly associated with a history of hypertension and recurrent stroke in patients with acute ischemic stroke.
  • These associations remain significant and independent of other risk factors like atrial fibrillation, diabetes, and hyperlipidemia.
  • Hypertensive stroke patients with hyperhomocysteinemia represent a high-risk group requiring intensified secondary prevention measures.
Abstract

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