Plasma Homocysteine is Associated with Aortic Arterial Stiffness but Not Wave Reflection in Chinese Hypertensive Subjects

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2014 Jan 30

PMID 24475061

Citations 13

Authors

Wenkai Xiao

Yongyi Bai

Ping Ye

Leiming Luo

Dejun Liu

Hongmei Wu

Jie Bai

Affiliations

Soon will be listed here.

Abstract

Objective: Elevated plasma total homocysteine (tHcy) acts synergistically with hypertension to exert a multiplicative effect on cardiovascular diseases risk. The aim of this study was to determine the relationship between tHcy concentration and blood pressure, and to evaluate the role of plasma tHcy in arterial stiffness and wave reflection in hypertension.

Methods: In this cross-sectional study, a community-based sample of 1680 subjects (mean age 61.6 years) was classified into four groups according to tHcy level (<21.6 vs. ≥ 21.6 µmol/l) and blood pressure (hypertensive vs. normotensive). Levels of plasma tHcy and other biochemical parameters (e.g., lipids, glucose) were determined. Central arterial blood pressure, reflected pressure wave, and carotid-femoral pulse wave velocity (cf-PWV) were assessed by tonometry within 2 days of obtaining the blood specimen.

Results: Neither peripheral nor central blood pressure differed according to tHcy levels in normotensive and hypertensive subjects. Differences in cf-PWV according to tHcy were observed only in hypertensive subjects; differences in cf-PWV in normotensive subjects were not significant after adjusting for confounding factors. Central augmentation index did not differ according to tHcy level in either normotensive or hypertensive subjects. Results of univariate analysis revealed significant correlations between blood pressure parameters and tHcy concentration only among normotensive subjects; however, these correlations were not significant in a partial correlation analysis. Results of multiple regression analysis showed that plasma tHcy levels were independently correlated with cf-PWV in hypertensive subjects (β = 0.713, P = 0.004). The independent relationship between tHcy and central augmentation index was not significant by further multiple analyses in normotensive or hypertensive individuals.

Conclusions: Plasma tHcy level is strongly and independently correlated with arterial stiffness measured as cf-PWV only in hypertensive subjects. Thus, hypertension is a major link between tHcy and aortic arterial stiffness.

Citing Articles

The relationship between homocysteine and cardiopulmonary exercise testing in patients with acute coronary syndrome after percutaneous coronary intervention.

Luo J, Zeng C, Zhao Y, Zeng Z BMC Cardiovasc Disord. 2023; 23(1):3.

PMID: 36609219 PMC: 9817365. DOI: 10.1186/s12872-022-02976-0.

Homocysteine predicts vascular target organ damage in hypertension and may serve as guidance for first-line antihypertensive therapy.

Carnagarin R, Nolde J, Ward N, Lugo-Gavidia L, Chan J, Robinson S J Clin Hypertens (Greenwich). 2021; 23(7):1380-1389.

PMID: 34137162 PMC: 8678735. DOI: 10.1111/jch.14265.

Hyperhomocysteinemia accompany with metabolic syndrome increase the risk of left ventricular hypertrophy in rural Chinese.

Yu S, Chen Y, Yang H, Guo X, Zheng L, Sun Y BMC Cardiovasc Disord. 2020; 20(1):44.

PMID: 32013876 PMC: 6998833. DOI: 10.1186/s12872-020-01350-2.

Noninvasive central pulse pressure is an independent determinant of renal function.

Xiao W, Wen Y, Ye P, Wang F, Cao R, Bai Y J Clin Hypertens (Greenwich). 2020; 22(2):234-242.

PMID: 31944554 PMC: 8029706. DOI: 10.1111/jch.13792.

Association of homocysteine with carotid-femoral pulse wave velocity in a southern Chinese population.

Wang T, Xu G, Cai X, Gong J, Xie Q, Xie L Aging (Albany NY). 2019; 11(21):9709-9718.

PMID: 31711045 PMC: 6874429. DOI: 10.18632/aging.102416.

References

Sutton-Tyrrell K, Bostom A, Selhub J, Zeigler-Johnson C . High homocysteine levels are independently related to isolated systolic hypertension in older adults. Circulation. 1997; 96(6):1745-9. DOI: 10.1161/01.cir.96.6.1745. View

Eikelboom J, Hankey G, Anand S, Lofthouse E, Staples N, Baker R . Association between high homocyst(e)ine and ischemic stroke due to large- and small-artery disease but not other etiologic subtypes of ischemic stroke. Stroke. 2000; 31(5):1069-75. DOI: 10.1161/01.str.31.5.1069. View

Yasmin , Brown M . Similarities and differences between augmentation index and pulse wave velocity in the assessment of arterial stiffness. QJM. 2000; 92(10):595-600. DOI: 10.1093/qjmed/92.10.595. View

Nygard O, Vollset S, Refsum H, Stensvold I, Tverdal A, Nordrehaug J . Total plasma homocysteine and cardiovascular risk profile. The Hordaland Homocysteine Study. JAMA. 1995; 274(19):1526-33. DOI: 10.1001/jama.1995.03530190040032. View

Yasmin , Falzone R, Brown M . Determinants of arterial stiffness in offspring of families with essential hypertension. Am J Hypertens. 2004; 17(4):292-8. DOI: 10.1016/j.amjhyper.2003.12.002. View

Mceniery C, Yasmin , Hall I, Qasem A, Wilkinson I, Cockcroft J . Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity: the Anglo-Cardiff Collaborative Trial (ACCT). J Am Coll Cardiol. 2005; 46(9):1753-60. DOI: 10.1016/j.jacc.2005.07.037. View

Miller A, Mujumdar V, Shek E, Guillot J, Angelo M, Palmer L . Hyperhomocyst(e)inemia induces multiorgan damage. Heart Vessels. 2001; 15(3):135-43. DOI: 10.1007/s003800070030. View

Hughes A, Park C, Davies J, Francis D, Thom S, Mayet J . Limitations of augmentation index in the assessment of wave reflection in normotensive healthy individuals. PLoS One. 2013; 8(3):e59371. PMC: 3609862. DOI: 10.1371/journal.pone.0059371. View

Woodside J, McMahon R, Gallagher A, Cran G, Boreham C, Murray L . Total homocysteine is not a determinant of arterial pulse wave velocity in young healthy adults. Atherosclerosis. 2004; 177(2):337-44. DOI: 10.1016/j.atherosclerosis.2004.07.001. View

10.

Lim U, Cassano P . Homocysteine and blood pressure in the Third National Health and Nutrition Examination Survey, 1988-1994. Am J Epidemiol. 2002; 156(12):1105-13. DOI: 10.1093/aje/kwf157. View

11.

Hu D, Xu X . [Prevention of stroke relies on valid control "H" type hypertension]. Zhonghua Nei Ke Za Zhi. 2009; 47(12):976-7. View

12.

Sacks D, Arnold M, Bakris G, Bruns D, Horvath A, Kirkman M . Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care. 2011; 34(6):e61-99. PMC: 3114322. DOI: 10.2337/dc11-9998. View

13.

Bortolotto L, Safar M, Billaud E, Lacroix C, Asmar R, London G . Plasma homocysteine, aortic stiffness, and renal function in hypertensive patients. Hypertension. 1999; 34(4 Pt 2):837-42. DOI: 10.1161/01.hyp.34.4.837. View

14.

Tsai J, Kuo H, Chiu Y, Hwang S, Chuang H, Chang J . Correlation of plasma homocysteine level with arterial stiffness and pulse pressure in hemodialysis patients. Atherosclerosis. 2005; 182(1):121-7. DOI: 10.1016/j.atherosclerosis.2005.01.038. View

15.

Nakhai-Pour H, Grobbee D, Bots M, Muller M, van der Schouw Y . Circulating homocysteine and large arterial stiffness and thickness in a population-based sample of middle-aged and elderly men. J Hum Hypertens. 2007; 21(12):942-8. DOI: 10.1038/sj.jhh.1002247. View

16.

Antoniades C, Antonopoulos A, Tousoulis D, Marinou K, Stefanadis C . Homocysteine and coronary atherosclerosis: from folate fortification to the recent clinical trials. Eur Heart J. 2008; 30(1):6-15. DOI: 10.1093/eurheartj/ehn515. View

17.

Weber T, Wassertheurer S, Rammer M, Haiden A, Hametner B, Eber B . Wave reflections, assessed with a novel method for pulse wave separation, are associated with end-organ damage and clinical outcomes. Hypertension. 2012; 60(2):534-41. DOI: 10.1161/HYPERTENSIONAHA.112.194571. View

18.

Wang H, Tan S, Song B, Miao W, Gao Y, Zhao L . [Correlation of H-type hypertension and prognosis of ischemic stroke]. Zhonghua Yi Xue Za Zhi. 2012; 92(17):1183-6. View

19.

van Dijk S, Smulders Y, Enneman A, Swart K, van Wijngaarden J, Ham A . Homocysteine level is associated with aortic stiffness in elderly: cross-sectional results from the B-PROOF study. J Hypertens. 2013; 31(5):952-9. DOI: 10.1097/HJH.0b013e32835eb6b9. View

20.

Vyssoulis G, Karpanou E, Kyvelou S, Adamopoulos D, Gialernios T, Gymnopoulou E . Associations between plasma homocysteine levels, aortic stiffness and wave reflection in patients with arterial hypertension, isolated office hypertension and normotensive controls. J Hum Hypertens. 2009; 24(3):183-9. PMC: 2845510. DOI: 10.1038/jhh.2009.50. View