Associations between plasma homocysteine levels, aortic stiffness and wave reflection in patients with arterial hypertension, isolated office hypertension and normotensive controls

Abstract

The aim of this study was to evaluate any possible association of homocysteine with arterial stiffness indices in patients with essential arterial hypertension (AH), isolated office hypertension (IOH) and normotensive controls. The final cohort comprised 231 normotensives (NTs, 119 males), 480 patients with IOH (196 males) and 1188 patients with essential AH (713 males). All patients were screened for plasma homocysteine levels and lipidaemic profile and underwent aortic compliance and wave reflection assessment by using carotid-femoral pulse wave velocity (PWVc-f) and aortic augmentation index corrected for heart rate (AIx) accordingly. In the total population, stepwise multiple linear regression analysis showed that homocysteine levels remained a significant determinant of PWV (beta (SE): 0.056 (0.007), P<0.001) and AIx (beta (SE): 0.236 (0.052), P<0.001) independently of the traditional factors affecting arterial stiffness and wave reflection. When the three groups were examined separately, homocysteine levels remained an independent determinant of PWFc-f in all groups (NT: beta (SE): 0.070 (0.022), P=0.002; IOH: beta (SE): 0.109 (0.015), P<0.001; AH: beta (SE): 0.040 (0.009), P<0.001). However, homocysteine levels remained an independent determinant of AIx only in the IOH and AH, but not in the NT group (IOH: beta (SE): 0.302 (0.124), P=0.015; AH: beta (SE): 0.183 (0.057), P=0.001; NT: beta (SE): 0.308 (0.240), P=0.200). This study points to an independent relationship between circulating homocysteine levels, aortic compliance and wave reflection.

Homocysteine, not high-sensitivity C-reactive protein, associates with the intima-media thickness of carotid artery and arterial stiffness

“…Earlier data suggest that homocysteine levels are associated with aortic stiffness in patients with type II diabetes mellitus (Anan et al, 2007) and arterial hypertension (Vyssoulis et al, 2010). In another study (de Bree et al, 2006), such an association between homocysteine levels and arterial stiffness indices was not indicated, pointing to a clear controversy at present.…”

“…The possible mechanisms of the relationship between homocysteine and arterial stiffness are not yet fully well established (Cohen et al, 2001;Spoelstra-De Man et al, 2005). However, it is known that elevated homocysteine levels induce oxidative injury to vascular endothelial cells and impair the production of nitric oxide, a strong relaxing factor by the endothelium (Tawakol et al, 1997;van den Bosch et al, 2003;Anan et al, 2007;Cohen et al, 2001;de Bree et al, 2006;Di Minno et al, 2010;Spoelstra-De Man et al, 2005;Vyssoulis et al, 2010). A significant positive association between hs-CRP and pulse wave velocity has been shown in healthy Japanese men, but the association may become insignificant after adjusting for conventional cardiovascular risk factor .…”

Interactions between plasma homocysteine and arterial stiffness in chronic kidney disease in community-dwelling individuals: The Maine-Syracuse Study

“…[14][15][16] The underlying cause of hyperhomocysteinemia, in renal disease, is not entirely understood but seems to be a consequence of the loss in renal function, with resulting abnormal tHcy metabolism and clearance. 5,17 There have been a number of reports of positive associations between plasma tHcy and PWV in populations at greater risk for CVD, such as those with type 2 diabetes mellitus, 18,19 hypertension 20,21 or prehypertension. 22 It has previously been reported in the Maine-Syracuse Longitudinal Study (MSLS) that decline in renal function over 4-5 years, as indicated by decline in estimated glomerular filtration rate (eGFR), was prospectively associated with higher values of carotid-femoral pulse PWV.…”

Homocysteine: An Emerging Cardiovascular Risk Factor that Never Really Made it~!2009-10-29~!2009-12-27~!2010-04-08~!

“…At the genetic level, tHcy alters the methylation status of genes thus contributing to altered gene expression [25,26]. Elevated Hcy levels were also associated with increased arterial stiffness in hypertensive patients [27].…”