Homocysteine, Ischemic Stroke, and Coronary Heart Disease in Hypertensive Patients: A Population-Based, Prospective

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Liyuan Han1, Qunhong Wu2, Changyi Wang1

  • 1From the Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China (L.H., J.Z., L.Z., R.F., Y.L., R.L., S.D.); Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, China (Q.W., Y.H.); Department of Chronic Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China (C.W., Z.C., T.Z., S.C., J.M., S.L., X.P.).

Stroke
|June 4, 2015
PubMed

Insights

High total homocysteine levels significantly increase ischemic stroke risk in Chinese hypertensive patients, but not coronary heart disease risk. Folic acid supplementation effectively lowers these homocysteine levels.

Area of Science:

  • Cardiovascular Research
  • Neurology
  • Public Health

Background:

  • Total homocysteine (tHcy) is a recognized risk factor for ischemic stroke (IS) and coronary heart disease (CHD).
  • Existing research is conflicting and primarily from developed countries, with limited focus on specific populations like hypertensive individuals.

Purpose of the Study:

  • To investigate the association between total homocysteine levels and the risk of IS and CHD in a Chinese population.
  • To evaluate the efficacy of folic acid supplementation in reducing tHcy levels among hypertensive patients.

Main Methods:

  • A prospective, population-based cohort study involving 5935 participants from Shenzhen, China.
  • Cox regression analysis to assess the risk of IS and CHD associated with tHcy levels.
  • Evaluation of folic acid supplementation's effect on tHcy in 501 hypertensive patients over 2.5 years.

Main Results:

  • Hyperhomocysteinemia was significantly associated with an increased risk of IS in the total, male, and female participants.
  • The highest tHcy category (≥30 μmol/L) showed a substantially elevated risk for IS, particularly in males.
  • No significant relationship was found between tHcy and the risk of coronary heart disease.
  • Folic acid supplementation for 2.5 years reduced tHcy levels by 27.92% in hypertensive patients.

Conclusions:

  • Hyperhomocysteinemia is a significant risk factor for IS in Chinese hypertensive patients, but not for CHD.
  • Folic acid supplementation demonstrates high efficiency in reducing elevated tHcy levels in this population.
Abstract

Keywords:
coronary heart diseasehomocysteinehypertensionischemiastroke

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