Micronutrient Deficiencies and Association With Hypertension: The Role of Folate, Vitamin B12, and Homocysteine

Folate and vitamin B12 are essential micronutrients involved in one-carbon metabolism. Deficiencies in these nutrients can elevate homocysteine levels, a recognized risk factor for hypertension. This study investigates the prevalence of folate and vitamin B12 deficiencies, hyperhomocysteinemia, and their association with hypertension in a North Indian population.

This cross-sectional study analyzed data from 1398 adult participants aged 30-75 years from rural Punjab, India. Biochemical parameters, including folate, vitamin B12, and homocysteine levels, were assessed using the Chemiluminescence Immunoassay technique. Hypertension was defined as SBP ≥ 140 mmHg and DBP ≥ 90 mmHg or the use of antihypertensive medication.

The findings revealed a sizable prevalence of folate (26.4%) and vitamin B12 (30.7%) deficiencies, along with a high prevalence of hyperhomocysteinemia (64.8%). Homocysteine levels showed an inverse relationship with folate and vitamin B12 levels, though this association was evident only up to a specific threshold. Further, hyperhomocysteinemia was associated with prehypertension and hypertension, and low folate with prehypertension. Paradoxically, a positive correlation was observed between folate levels and blood pressure.

These findings underscore the widespread prevalence of micronutrient deficiencies and hyperhomocysteinemia and their potential association with hypertension. The study also highlights the importance of establishing upper cutoff levels for folate and vitamin B12 to refine dietary and supplementation guidelines. The positive correlation between folate levels and blood pressure suggests potential interference with cellular nutrient uptake in hypertensive individuals, warranting further investigation.