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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

Hyperhomocysteinemia is a significant risk factor for silent cerebral infarction in patients with chronic renal

Futoshi Anan1, Naohiko Takahashi, Tsuyoshi Shimomura

  • 1Department of Cardiology, Oita Red Cross Hospital, and Department of Cardiovascular Science, School of Medicine, Oita University, Oita 879-5593, Japan. anan-f@med.oita-u.ac.jp

Metabolism: Clinical and Experimental
|April 25, 2006
PubMed

Insights

Elevated plasma total homocysteine (tHcy) is linked to silent cerebral infarction (SCI) in hemodialysis patients. This finding suggests tHcy may predict SCI in those with chronic renal failure.

Area of Science:

  • Nephrology
  • Neurology
  • Cardiovascular Science

Background:

  • Silent cerebral infarction (SCI) is a significant predictor of mortality in hemodialysis (HD) patients.
  • Elevated plasma total homocysteine (tHcy) is associated with renal dysfunction and cerebrovascular events.

Purpose of the Study:

  • To investigate the correlation between plasma tHcy levels and the presence of SCI in patients undergoing HD.
  • To identify potential risk factors for SCI in this patient population.

Main Methods:

  • 44 HD patients were categorized into with-SCI (n=24) and without-SCI (n=20) groups based on brain MRI.
  • 24-hour ambulatory blood pressure monitoring was conducted.
  • Plasma tHcy, lipid profiles, and demographic data were analyzed.

Main Results:

  • The with-SCI group exhibited higher rates of smoking, lower high-density lipoprotein cholesterol, and significantly higher plasma tHcy levels (P<.0001).
  • Higher nighttime systolic blood pressure and mean heart rate were observed in the with-SCI group.
  • Multivariate analysis identified hyperhomocysteinemia as an independent risk factor for SCI (OR, 1.22; P<.01).

Conclusions:

  • Plasma tHcy is a significant and independent risk factor for SCI in patients with chronic renal failure on HD.
  • Elevated tHcy may serve as a novel predictive marker for SCI in this vulnerable population.

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