Background: This study aimed to determine the prevalence of hyperhomocysteinemia and folate status in a sample of normal healthy Nigerians living in Zaria as well as assess the relationship between homocysteine, folate, and blood pressure (BP) levels. Methods: It was a cross-sectional analytical study carried out among 65 normal healthy volunteers aged 18–65 years. Participants were randomly selected from willing patient escorts, hospital employees, and willing staff presenting at the Ahmadu Bello University Medical Centre, Zaria and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. The percentage of participants who had high homocysteine levels as well as their plasma folate status was determined. Results: There were 9.2% with hyperhomocysteinemia >15 μmol/L and 51% with hyperhomocysteinemia >10 μmol/L. The mean plasma homocysteine level was 10.8 ± 2.7 μmol/L with male and female values of 10.7 ± 2.6 and 10.8 ± 2.8, respectively ( P = 0.87). The mean plasma folate level was high (116.7 ± 44.0 ng/mL) with male value of (111.5 ± 44.9 ng/mL) which did not differ significantly ( P = 0.37) from that of females (121.4 ± 43.3 ng/mL). Homocysteine showed a positive significant ( P = 0.01) relationship with folate but not with BP's ( P > 0.05). Conclusion: There is a high prevalence of hyperhomocysteinemia in normal healthy Northern-Nigerians which cannot be accounted for by suboptimal folate levels. Hyperhomocysteinemia may not be a risk factor for cardiovascular disease in normal healthy Nigerians despite its high levels as it showed no significant relationship with BP. Context: L’ étude vise à determiner la prévalence de l’hyper-homocystéinémie de l’état du folate en prenant comme echantillon dans le cas du nigérian en bonne santé vivant à Zaria, ainsi que l’évaluation de la relation qui existe entre l’homocystéine, le folate par rapport au niveau de croissance de la pression artérielle.

Objectives: This study was aimed at determining the effect of folic acid adjunct therapy on homocysteine (HCY) and blood pressure (BP) levels in hypertensive subjects. Method: The study was a double blind placebo-controlled trial on 100 hypertensive patients randomised into 50 folate and 50 placebo groups, where the folate group had 5 mg folic acid daily for 8 weeks. Fasting plasma homocysteine, folate and blood pressure levels were determined at baseline, at 4 and at 8 weeks. The Mixed Model Repeated Measures analysis of variance was applied for data analysis. Results: Hyperhomocysteinaemia was found at baseline in the folate (21.3 ± 5.7 µmol/L) and placebo (21.6 ± 4.9 µmol/L) groups which did not differ statistically (p > 0.05). Folic acid adjunct therapy, reduced homocysteine levels at 4 weeks by 2.0 µmol/L (9.2 %, p < 0.05) and at 8 weeks by 1.2 µmol/L (5.6 %, p < 0.05), with no significant (p > 0.05) systolic and diastolic blood pressure lowering effect. High base-line folate levels were found in both folate (113.8 ± 51.2 ng/ml) and placebo groups (109.5 ± 51.4 ng/ml) with no statistically significant difference (p > 0.05). Conclusion: Short-term daily folic acid supplementation over 8 weeks had a significant homocysteine reduction effect with no significant reduction in systolic and diastolic blood pressures of hypertensive subjects in Zaria, Nigeria. Hyperhomocysteinaemia could not be accounted for by suboptimal folate levels. Keywords: Hypertension, Homocysteine, Blood pressure, Folate, Placebo, Nigeria.

Background: The relationship of diet with stroke risk among Africans is not well understood. Aim: To investigate the association between dietary patterns and stroke risk among West Africans. Methods: In this multi-centre case-control study, 3684 stroke patients matched (for age and sex) with 3684 healthy controls were recruited from Nigeria and Ghana. Food consumption was assessed using a food frequency questionnaire, and dietary patterns were summarized using principal component analysis. Stroke was defined using predefined criteria primarily on clinical evaluation following standard guidelines. Conditional logistic regression was applied to compute odds ratio (OR) and 95% confidence interval (CI) for stroke risk by tertiles of dietary patterns. Results: Overall, mean age was 59.0±13.9 years, and 3992(54.2%) were males. Seven dietary patterns were identified. Multivariable-adjusted OR (95%CI) for risk of stroke by second and third tertiles (using the lowest (first) tertile as reference) of dietary patterns were; 1.65 (1.43, 1.90) and 1.74 (1.51, 2.02) respectively for ‘poultry product and organ meat’; 1.69 (1.47, 1.96 and, 1.51 (1.31, 1.75) for ‘red meat’; 1.07 (0.92, 1.23) and 1.21 (1.04, 1.40) for ‘fried foods and sweetened drinks’; 0.69 (0.60, 0.80) and 0.45 (0.39, 0.53) for ‘vegetables’; 0.84 (0.72, 0.97) and 0.81 (0.70, 0.93) for ‘whole-grain and fruit drinks’; and 0.97 (0.84, 1.12) and 0.85 (0.73, 0.98) for ‘fruits’ (P<0.05). Conclusions: These data suggest that plant-based diets are associated with a lower risk of stroke and might be a beneficial dietary recommendation for the primary prevention of stroke among Africans.

Background: This study aimed at evaluating the prevalence of hyperhomocysteinaemia in Northern-Nigerian hypertensives and its association with hypertension severity and some major determinants as data regarding these are lackingin sub-Saharan Africa. Method: A Community-based cross-sectional study done on 120 randomly-selected hypertensive patients who responded to an ABU radio frequency modulated invitation for free health-screening at the Ahmadu Bello University (ABU) Medical Centre from January 2016 to June 2016. The percentage of participants with high homocysteine levels, their anthropometric parameters and blood pressures were determined. Plasma homocysteine (hcy) was classified as normal (5-15), moderate (>15-30), intermediate (31-100) and severe (>100) μmol/L. Kruskal-Wallis test was applied and log-transformed homocysteine (Ln10Homocysteine) was correlated with systolic and diastolic blood pressures as well as age, body mass index, fasting blood glucose, glomerular filtration rate, hypertension duration and Ln10folate in males and females using the Pearson’s Correlation analysis. Results: There were 83(69.2%) females and 37(30.8%) males with Median homocysteine of 20.8 μmol/L and 22.0 μmol/L respectively (p=0.003). Hyperhomocysteinaemia was found in 118(98.3%) hypertensives while 2(1.7%) subjects had normo-homocysteinaemia. Moderate hyperhomocysteinaemia (Median, 20.8 μmol/L) was identified in 105(87.5%) and intermediate (Median, 40 μmol/L) in 13(10.8%) (p<0.001). No subject had severe hyperhomocysteinaemia.Homocysteine was higher (p=0.003) in subjects with Stage 2 systolic hypertension. Ln10Homocysteine was significantly (p<0.001) correlated with blood pressure (SBP: r=0.45; DBP: r=0.40) and age (r=0.33). Conclusion: The prevalence of hyperhomocysteinaemia in North-Western Nigerian hypertensives is high as against normal healthy controls. Plasma homocysteine is higher with severe systolic hypertension and positively associated with age. Keywords: Hypertension, Homocysteine, Blood pressure, Northern-Nigerians Funding: No specific grants but Micro Nova Pharmaceuticals Limited, Nigeria and Emzor Pharmaceutical Industries, Lagos, Nigeria supported with drugs.