Exploration of the risk factors of essential hypertension with hyperhomocysteinemia: A hospital-based study and nomogram analysis

Abstract

OBJECTIVES: To explore the risk factors of essential hypertension with hyperhomocysteinemia (H-type hypertension) and design a nomogram to predict this risk. METHODS: A hospital-based study was conducted on 1,712 individuals, including 282 patients with H-type hypertension, 105 patients with simple hypertension, 645 individuals with hyperhomocysteinemia, and 680 healthy controls. Logistic regression and nomogram models were applied to evaluate the risk factors. RESULTS: Logistic regression showed that advanced age, male sex, high body mass index (BMI), high total cholesterol levels, high glucose levels, and high creatinine levels were risk factors of H-type hypertension in the healthy population and were integrated into the nomogram model. Advanced age, male sex, high BMI, high total cholesterol levels, and high glucose levels were shown to be risk factors of H-type hypertension in the hyperhomocysteinemia population. Male sex and high creatinine levels were shown to be risk factors of H-type hypertension in the hypertension population. Nomogram analysis showed that the total factor score ranged from 106 to 206, and the corresponding risk rate ranged from 0.05 to 0.95. CONCLUSIONS: Men are more likely to have H-type hypertension, and advanced age, high BMI, high total cholesterol levels, and high glucose levels are risk factors of H-type hypertension in healthy and hyperhomocysteinemia populations. Furthermore, high creatinine level is a risk factor of H-type hypertension in healthy and hypertension populations. Nomogram models may be used to intuitively evaluate H-type hypertension risk and provide a basis for personalized interventions.

Impact of Helicobacter pylori-Related Metabolic Syndrome Parameters on Arterial Hypertension

“…Furthermore, atrophic gastritis owing to H. pylori infection with or without MetS induces vitamin B12 and folic acid deficiency, which results in hyperhomocysteinemia with subsequent damage to the vascular endothelial cells [111,112]; H. pylori-induced chronic gastritis can result in vitamin B12 and folate malabsorption, leading to methylation by 5-methyl-tetrahydrofolic acid failure and, hence, homocysteine accumulation. Hyperhomocysteinemia is a potent contributor to vascular disorders [111], an independent risk factor for MetS-related atherosclerosis [113], and a risk factor for arterial hypertension [114]. Specifically, homocysteine inhibits the secretion of nitric oxide by endothelial cells and trig-gers thromboxane-mediated platelet aggregation and vasoconstriction; it causes endothelial cell injury, promotes smooth muscle cell proliferation, and attenuates the protective effect of endothelial cell-derived relaxation agents [115]; and hyperhomocysteinemia, hyperfibrinogenemia, and high lipoprotein-a (a low density lipoprotein-like particle which contains the plasminogen homologue apo(a) disulfide-bound to apo B), as three 'non-conventional' coronary artery disease risk factors, may promote the occurrence of atherosclerosis and sequelae, including arterial hypertension [116].…”

“…(1) vascular endothelial cells damage and (2) MetS-related atherosclerosis-arterial hypertension [111][112][113][114][115][116] Diastolic blood pressure Higher concentrations of H. pylori/MetS-related fibrinogen → inhibition of endothelial nitric oxide and nitric oxide synthase → vasoconstriction and augmented peripheral vascular tension but not cardiac output → isolated diastolic blood pressure [117,118] CagA, Cytotoxin-associated gene A; H. pylori, Helicobacter pylori; MetS, metabolic syndrome; VacA, vacuolating cytotoxin A.…”

Analysis of the Correlation between the Distribution of MTHFR Gene and the Severity and Renal Function of Elderly Patients with H-Type Hypertension

“…The ratio of technical secondary school or below to college or above is 84/89 cases. Inclusion criteria of the observation group: (1) H-type hypertension is diagnosed with Hcy ≥10 umol/L according to the diagnostic criteria of Chinese H-type hypertension expert consensus on diagnosis and treatment in 2016 [ 5 ]; (2) unconscious disorders and communication disorders can actively cooperate with research and examination and other operations [ 6 – 8 ]; (3) not in menstruation, pregnancy, and lactation [ 9 , 10 ]; (4) clear research content and sign informed consent voluntarily [ 11 , 12 ]; and (5) age ≥45. Exclusion criteria are as follows: (1) secondary hypertension [ 13 , 14 ]; (2) systemic blood diseases, infectious diseases, and immune system diseases [ 15 , 16 ]; (3) surgical treatment or blood transfusion within 3 months before the study [ 17 , 18 ]; (4) suffering from malignant tumor [ 19 , 20 ]; and (5) those who took vitamin B12, vitamin B6, folic acid, or other substances that affected serum Hcy level in the last 3 months [ 21 ].…”

Role of homocysteine metabolism in the development of endothelial dysfunction and hypertension in patients with multiple myeloma

“…По данным больничного исследования, мужчины чаще, чем женщины страдают так называемой гипертонией H-типа (связанной с гипергомоцистеинемией). Возраст, высокий индекс массы тела, высокий уровень общего холестерина и высокий уровень глюкозы являются ФР гипертонии H-типа у здоровых людей и людей с гипергомоцистеинемией [37].…”