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Does homocysteine cause hypertension?

Coen D A Stehouwer1, Coen van Guldener

  • 1Department of Internal Medicine, Institute of Cardiovascular Research, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. cda.stehouwer@vumc.nl

Clinical Chemistry and Laboratory Medicine
|December 6, 2003
PubMed
Summary

High homocysteine levels correlate with increased blood pressure, particularly systolic pressure. While homocysteine-lowering therapies show promise, the causal link requires further investigation in ongoing studies.

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Area of Science:

  • Cardiovascular epidemiology
  • Nutritional biochemistry

Background:

  • Plasma homocysteine levels are associated with blood pressure in several population-based studies.
  • An increase of 5 micromol/l in plasma homocysteine correlated with a 0.7/0.5 mmHg rise in systolic/diastolic blood pressure in men and 1.2/0.7 mmHg in women, independent of renal function and B vitamin status.

Purpose of the Study:

  • To investigate the association between plasma homocysteine levels and blood pressure.
  • To explore the potential causal relationship and underlying mechanisms linking homocysteine to hypertension.
  • To evaluate the impact of homocysteine-lowering therapies on blood pressure.

Main Methods:

  • Analysis of epidemiological data linking plasma homocysteine levels to blood pressure measurements.
  • Review of observational studies on homocysteine-lowering therapies and their effect on blood pressure.

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  • Consideration of proposed biological mechanisms, including arteriolar constriction and renal dysfunction.
  • Main Results:

    • A positive association was observed between plasma homocysteine and both systolic and diastolic blood pressure.
    • Homocysteine-lowering treatments with folic acid-based regimens have been linked to decreased blood pressure.
    • Mechanisms such as homocysteine-induced arteriolar constriction, renal dysfunction, and increased arterial stiffness are proposed but lack direct human evidence.

    Conclusions:

    • The hypothesis that homocysteine increases blood pressure is currently considered unproven due to potential confounding factors.
    • Further large-scale intervention studies are needed to confirm if homocysteine-lowering vitamins effectively reduce blood pressure and cardiovascular morbidity.
    • The results highlight the need for continued research into the complex relationship between homocysteine, blood pressure, and cardiovascular health.