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Association between low red blood cell 5-methyltetrahydrofolate and hyperhomocysteinaemia with hypertension : a

Jamal Golbahar1, Esmael Mostafavi

  • 1Department of Molecular Medicine, Al-Jawhara Centre for Genetic Diagnosis and Research, College of Medicine and Medical Sciences, AGU, PO Box 26771, Bahrain. jamalgo@agu.edu.bh

High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension
|February 23, 2013
PubMed

Insights

Low red blood cell 5-methyltetrahydrofolate (5-MTHF) is linked to a higher risk of hypertension in men. Folate levels in red blood cells appear to be a reliable indicator of 5-MTHF deficiency and its connection to hypertension.

Area of Science:

  • Cardiovascular Health
  • Nutritional Biochemistry
  • Metabolic Pathways

Background:

  • Hypertension is a prevalent cardiovascular risk factor, with associations to hyperhomocysteinemia and related metabolic pathways. The role of specific folate metabolites, like 5-methyltetrahydrofolate (5-MTHF), in hypertension remains unclear. Previous studies have explored links between plasma total homocysteine (tHcy) and hypertension, but the significance of intracellular folate status is less understood.
  • The homocysteine re-methylation pathway is crucial for cellular metabolism and involves key nutrients like vitamin B12 and folate. Disturbances in this pathway can lead to elevated homocysteine levels, a known cardiovascular risk factor. Understanding the interplay between pathway components and blood pressure regulation is essential for comprehensive risk assessment.

Purpose of the Study:

  • To investigate the association between hypertension and key components of the homocysteine re-methylation pathway, including plasma total homocysteine (tHcy), vitamin B12, plasma 5-methyltetrahydrofolate (5-MTHF), and red blood cell 5-MTHF (RBC 5-MTHF).
  • To determine if RBC 5-MTHF serves as a reliable marker for long-term folate status and if low RBC 5-MTHF levels are specifically associated with an increased risk of hypertension.

Main Methods:

  • A cross-sectional study involving 492 males and 431 females from a community-based setting.
  • Measurement of blood pressure (systolic and diastolic) and fasting blood samples for biochemical analyses, including plasma tHcy, creatinine, uric acid, lipids, plasma 5-MTHF, RBC 5-MTHF, and vitamin B12.
  • Statistical analysis to assess the association between hypertension and homocysteine pathway components, adjusted for potential confounders like BMI, age, dyslipidemia, and smoking.

Main Results:

  • In males, a 1.8-fold increased risk of hypertension was observed in the lowest quartile of RBC 5-MTHF compared to the highest quartile, after adjusting for multiple risk factors (95% CI 1.9, 8.7; p = 0.003).
  • A 1.1-fold increased risk of hypertension was associated with the highest quartile of plasma tHcy compared to the lowest, after comprehensive adjustments (95% CI 1.1, 9.2; p = 0.03).
  • No significant associations between hypertension and plasma tHcy or other homocysteine re-methylation pathway components were found in females.

Conclusions:

  • Low RBC 5-MTHF demonstrated a stronger association with hypertension risk in males than other measured components of the homocysteine re-methylation pathway.
  • Folate measurements within red blood cells (RBC 5-MTHF) appear to be the most accurate marker for identifying 5-MTHF deficiency and related disturbances in the homocysteine re-methylation pathway concerning hypertension.
  • These findings highlight the potential clinical utility of assessing RBC 5-MTHF levels for hypertension risk stratification, particularly in males.
Abstract

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