Hyperhomocysteinemia: an additional risk factor in white coat hypertension

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Published on: May 17, 2024

Asli Curgunlu1, Yesari Karter, Hafize Uzun

  • 1Department of Internal Medicine, Cerrahpasa Medical Faculty, Taksim Public Hospital, Istanbul University, Eminonu, Turkey.

International Heart Journal
|May 7, 2005
PubMed

Insights

White coat hypertension (WCH) is linked to elevated homocysteine levels, indicating increased cardiovascular disease risk. These findings suggest WCH is not an innocent condition and warrants further attention.

Area of Science:

  • Cardiology
  • Clinical Biochemistry

Background:

  • Sustained hypertension (HT) association with homocysteine is known.
  • White coat hypertension (WCH) requires assessment for cardiovascular disease (CVD) risk factors.
  • WCH is defined as clinical hypertension with daytime ambulatory blood pressure < 135/85 mmHg.

Purpose of the Study:

  • To evaluate plasma homocysteine levels in patients with WCH.
  • To determine if WCH is associated with elevated homocysteine, a CVD risk indicator.
  • To compare homocysteine levels across WCH, sustained hypertension (HT), and normotensive (NT) groups.

Main Methods:

  • Plasma homocysteine levels were measured using ELISA in 100 subjects (33 WCH, 35 HT, 32 NT).
  • Subjects were matched for age, gender, and BMI; smokers, dyslipidemic, and diabetic patients were excluded.
  • Evaluated urinary albumin excretion (UAE), creatinine clearance, hypertensive retinopathy, and left ventricular mass index (LVMI).

Main Results:

  • Plasma homocysteine was significantly higher in WCH (12.32 ± 1.07 µmol/L) than NT controls (5.35 ± 1.38 µmol/L; P < 0.001).
  • WCH homocysteine levels were lower than in sustained hypertensives (19.03 ± 0.76 µmol/L; P < 0.001).
  • WCH group showed less severe hypertensive retinopathy and lower LVMI than HT group, but higher LVMI than NT group.

Conclusions:

  • WCH is associated with elevated plasma homocysteine levels.
  • The increase in homocysteine in WCH, though less than in sustained HT, signifies potential CVD risk.
  • Target organ damage in the WCH group suggests it should not be considered benign.

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