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The differential diagnostic value of serum homocysteine for white coat hypertension

Shitian Guo1, Hui Lin2,3, Sunlei Pan2,3

  • 1School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.

Oncotarget
|December 20, 2017
PubMed

Insights

Serum homocysteine (Hcy) levels are lower in white coat hypertension (WCH) patients compared to hypertensive patients. Hcy shows potential as a biomarker for differentiating WCH.

Area of Science:

  • Cardiology
  • Clinical Biochemistry
  • Hypertension Research

Background:

  • Differentiating white coat hypertension (WCH) from sustained hypertension is crucial for appropriate patient management.
  • Serum homocysteine (Hcy) has been implicated in cardiovascular disease, but its role in WCH diagnosis is less understood.

Purpose of the Study:

  • To evaluate the diagnostic value of serum homocysteine (Hcy) in distinguishing white coat hypertension (WCH) from sustained hypertension.
  • To compare the efficacy of Hcy with other biomarkers like NT-pro-BNP and cystatin C in WCH diagnosis.

Main Methods:

  • A combined retrospective and prospective study design.
  • Utilized 24-hour ambulatory blood pressure monitoring (ABPM) data and clinical parameters.
  • Employed Pearson correlation analysis and Receiver Operating Characteristic (ROC) curve analysis to assess Hcy's diagnostic performance.

Main Results:

  • Serum Hcy levels were significantly lower in WCH patients compared to hypertensive patients (P < 0.001).
  • Hcy demonstrated good diagnostic accuracy for WCH with an AUC of 0.80 in the retrospective and 0.73 in the prospective study.
  • Hcy outperformed NT-pro-BNP and cystatin C individually, and a combination of biomarkers including Hcy improved diagnostic indication.

Conclusions:

  • Serum homocysteine (Hcy) is a potential biomarker for the differential diagnosis of white coat hypertension (WCH).
  • Lower Hcy levels are associated with WCH, aiding in its distinction from sustained hypertension.
Abstract

Keywords:
ABPMHcydiagnosishypertensionwhite coat hypertension

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