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Relationship between homocysteine levels and hypertension in systemic lupus erythematosus

José Mario Sabio¹, José Antonio Vargas-Hitos, Josefina Martinez-Bordonado

¹Virgen de las Nieves University Hospital, Granada, Spain.

Arthritis Care & Research

|April 3, 2014

Insights

Elevated homocysteine levels are linked to higher blood pressure and hypertension in women with systemic lupus erythematosus (SLE). This suggests homocysteine may increase cardiovascular risk in SLE patients.

Area of Science:

Rheumatology
Cardiovascular Medicine
Clinical Chemistry

Background:

Homocysteine is associated with atherosclerosis and hypertension in the general population.
Limited data exists on homocysteine's impact on blood pressure and arterial stiffness in systemic lupus erythematosus (SLE).

Purpose of the Study:

To investigate the association between homocysteine levels, hypertension (HT), and arterial stiffness in women with SLE.

Main Methods:

A cross-sectional study included 99 women with SLE and 101 matched controls without cardiovascular disease or diabetes.
Measurements included homocysteine levels, cardiovascular risk factors, and carotid-femoral pulse wave velocity (PWV) for arterial stiffness.
Univariate and multivariate analyses examined associations between homocysteine, systolic blood pressure (SBP), PWV, and HT.

Main Results:

Women with SLE had significantly higher homocysteine levels, PWV, SBP, hyperhomocysteinemia prevalence, and HT prevalence compared to controls.
Homocysteine positively correlated with SBP and PWV in SLE patients but not controls.
SBP was independently associated with homocysteine and BMI; HT was independently associated with homocysteine, BMI, and prednisone dose in SLE patients.

Conclusions:

Homocysteine is independently associated with SBP and HT in women with SLE.
Elevated homocysteine may contribute to an increased risk of hypertension in SLE patients.

Read full analysis

Abstract

Objective:

Homocysteine has been linked to atherosclerosis and hypertension (HT) in the general population. However, there is limited evidence regarding the effect of homocysteine on blood pressure and arterial stiffness in systemic lupus erythematosus (SLE). We examined whether homocysteine is associated with HT and arterial stiffness in women with SLE.

Methods:

In total, 99 women with SLE without a history of cardiovascular disease or diabetes mellitus and 101 matched controls were included in this cross-sectional study. Participants were analyzed for homocysteine levels, cardiovascular risk factors, and arterial stiffness assessed by means of carotid-femoral pulse wave velocity (PWV). Associations between homocysteine, systolic blood pressure (SBP), PWV, and HT were tested using univariate and multivariate analyses.

Results:

Homocysteine levels (mean ± SD 12.3 ± 4.8 versus 9.3 ± 3.8 μmoles/liter), PWV (mean ± SD 7.54 ± 1.1 versus 7.10 ± 1.1 meters/second), SBP (mean ± SD 119 ± 13 versus 115 ± 12 mm Hg), and the prevalence of hyperhomocysteinemia (23% versus 7%) and HT (43% versus 12%) were significantly higher in women with SLE (P < 0.050 for all). In the univariate analysis, homocysteine correlated positively with SBP (P = 0.001) and PWV (P = 0.023) in women with SLE but not in controls. In the multiple linear regression analysis, SBP was independently associated with homocysteine and body mass index (BMI) in women with SLE. Similarly, in the multivariate logistic regression analysis, homocysteine levels (or hyperhomocysteinemia), BMI, and daily prednisone dose were independently associated with HT in women with SLE.

Conclusion:

Homocysteine was independently associated with SBP and HT in women with SLE, but not in controls. Elevated homocysteine levels could increase the risk of HT in SLE.

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