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Hyperhomocysteinemia predicts total and cardiovascular mortality in high-risk women

Gian Paolo Rossi1, Giuseppe Maiolino, Teresa Maria Seccia

  • 1Department of Clinical and Experimental Medicine, Internal Medicine 4, University Hospital, Padua, Italy. gianpaolo.rossi@unipd.it

Journal of Hypertension
|April 14, 2006
PubMed

Insights

High homocysteine levels are common in high-risk women and increase cardiovascular mortality, particularly in hypertensive individuals. However, homocysteine levels did not correlate with the severity of coronary artery disease (CAD).

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Genetics

Background:

  • Elevated homocysteine is linked to cardiovascular disease (CVD), potentially more so in women.
  • The association in high-risk women with coronary artery disease (CAD) remains unclear.

Purpose of the Study:

  • To investigate the link between hyperhomocysteinemia and CAD in high-risk women.
  • To assess the association with cardiovascular mortality in hypertensive and normotensive cohorts.

Main Methods:

  • Prospective cohort study of 262 Caucasian postmenopausal women undergoing coronary angiography.
  • Assessed total plasma homocysteine (tHcy), folate levels, and MTHFR polymorphism.
  • Defined hyperhomocysteinemia as tHcy ≥ 15 micromol/l; primary outcome was cardiovascular mortality.

Main Results:

  • Hyperhomocysteinemia was prevalent (16.7% combined) but not associated with CAD severity.
  • High tHcy levels correlated with worse all-cause and cardiovascular mortality.
  • In hypertensive women, hyperhomocysteinemia significantly increased cardiovascular mortality.

Conclusions:

  • Hyperhomocysteinemia is common in high-risk women and negatively impacts prognosis.
  • Homocysteine levels are not associated with the atherosclerotic burden of CAD.
  • Hyperhomocysteinemia is a significant risk factor for cardiovascular mortality in high-risk women, especially those with hypertension.
Abstract

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