Relationship of homocysteine with cardiovascular disease and blood pressure

Area of Science:

• Cardiovascular Medicine
• Metabolic Health
• Epidemiology

Background:

• Elevated plasma homocysteine (Hcy) is a potential risk factor for cardiovascular disease (CVD) and hypertension.
• The exact role of Hcy in CVD pathogenesis remains unclear despite established links to hyperhomocysteinemia and cardiovascular events.
• Plasma Hcy levels increase with age and correlate with lifestyle factors like smoking and diet.

Purpose of the Study:

• To investigate the association between plasma homocysteine levels and cardiovascular disease and hypertension.
• To clarify the independent contribution of Hcy to cardiovascular risk, considering its association with other risk factors.
• To evaluate the potential benefits of Hcy reduction, particularly in specific populations like the elderly.

Main Methods:

• Review of epidemiologic and longitudinal clinical investigations examining plasma Hcy and cardiovascular/cerebral events.
• Analysis of studies assessing the relationship between Hcy and blood pressure levels.
• Consideration of research on the impact of vitamin supplementation on Hcy levels.

Main Results:

• Most studies report an association between plasma Hcy and the risk of cardiovascular and cerebral events.
• Some studies indicate a significant relationship between Hcy and blood pressure, with higher levels in hypertensive individuals.
• The independent effect of Hcy on CVD or hypertension is difficult to ascertain due to its cosegregation with other risk factors.

Conclusions:

• The precise independent role of plasma homocysteine in cardiovascular disease and hypertension is not definitively established.
• Hcy reduction, potentially through vitamin supplementation, may offer benefits for cardiovascular risk reduction, especially in the elderly.
• Assessment and management of Hcy should be integrated within a broader strategy addressing other modifiable cardiovascular risk factors.