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Coronary flow velocity reserve is impaired in hypertensive patients with hyperhomocysteinemia

J Liu1, Y Xu1, H Zhang1

  • 1Department of Endocrinology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, People's Republic of China.

Journal of Human Hypertension
|March 28, 2014
PubMed

Insights

High homocysteine (HHcy) levels combined with hypertension significantly impair coronary artery endothelial function. This damage may be linked to insulin resistance, highlighting a critical link between HHcy, hypertension, and cardiovascular health.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Hyperhomocysteinemia (HHcy) is a known risk factor for coronary artery disease.
  • Homocysteine (Hcy) impacts insulin sensitivity and can cause endoplasmic reticulum stress in adipose tissue.
  • The combined impact of chronic HHcy and hypertension on coronary artery endothelial function remains unclear.

Purpose of the Study:

  • To investigate the combined effects of chronic HHcy and hypertension on coronary artery endothelial function.
  • To assess the relationship between Hcy levels, insulin resistance, and endothelial function in hypertensive patients.

Main Methods:

  • Fifty-one patients with essential hypertension (HT) were divided into groups with (H-type HT) and without (nHT) HHcy.
  • Forty healthy subjects served as controls.
  • Coronary artery endothelial function was assessed using coronary flow velocity reserve (CFVR).
  • Insulin resistance was evaluated using the homeostasis model assessment (HOMA-IR).

Main Results:

  • Hypertensive patients exhibited higher Hcy levels and lower CFVR compared to controls.
  • Hcy levels were negatively correlated with CFVR.
  • The H-type HT group showed significantly higher insulin resistance and lower CFVR compared to the nHT group.
  • Coronary artery endothelial function was impaired in hypertensive patients with HHcy.

Conclusions:

  • Combined chronic HHcy and hypertension impair coronary artery endothelial function.
  • Insulin resistance induced by HHcy may contribute to endothelial dysfunction in hypertensive patients.
  • These findings suggest a significant interplay between HHcy, hypertension, insulin resistance, and cardiovascular health.

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