Plasma sulfhydryl-containing amino acids in patients with cerebral infarction and in hypertensive subjects

Araki, Atsushi; Sako, Y; Fukushima, Yutaka; Matsumoto, Mitsuhiro; Asada, Takeo; Kita, Toru

doi:10.1016/0021-9150(89)90118-4

Cited by 194 publications

(88 citation statements)

References 23 publications

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“…Thus our results suggest that modest hyperhomocysteinaemia could promote microvascular complications through enhancing the risk for hypertension. These findings support the results of the few previous investigations with mainly small sample sizes which also showed an association of mild hyperhomocysteinaemia with hypertension [14,15], or systolic hypertension in non-diabetic patients [24], and with diastolic blood pressure in Type II diabetic patients [16]. Our results are also in line with those of very large cohort based investigations on non-diabetic subjects.…”

Section: Discussionsupporting

confidence: 93%

“…Adjustment of the study results for GFR, the more sensitive predictor of renal function, however, has been done by only a few investigators recently. The association of increased tHcy concentrations with age [15], diabetic retinopathy [35], and nephropathy has been shown to be closely related to declining GFR below a normal value of 80 ml·min·(1.73 m 2 ) -1 [35,36]. After adjustment for GFR, tHcy remained a strong predictor for CHD disease in normotensive Type II diabetic patients, but not for diabetic nephropathy [35,36] or retinopathy [35].…”

Section: Discussionmentioning

confidence: 99%

“…Increased tHcy concentrations were also suggested to be related to hypertension in non-diabetic patients [14,15] also to mean blood pressure and to diastolic blood pressure in Type II (non-insulin-dependent) diabetic patients [16]. However, it has not been investigated yet, whether tHcy and/or MTHFR gene polymorphism have an additive effect on hypertension in diabetes mellitus.…”

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confidence: 99%

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Total plasma homocysteine is associated with hypertension in Type I diabetic patients

et al. 2002

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Aims/hypothesis. Although hyperhomocysteinaemia and methylenetetrahydrofolate reductase gene polymorphism are accepted risk factors for cardiovascular disease, their association with micro angiopathy or blood pressure in diabetic patients is still being debated. This study explores the relation between plasma homocysteine concentrations, methylenetetrahydrofolate reductase gene polymorphism, hypertension, diabetic microvascular and macrovascular complications associated with kidney function. Methods. Vascular complications, hypertension, methylenetetrahydrofolate reductase genotype (RFLP with Hinf I digestion), and total plasma homocysteine (HPLC) were investigated in 389 well-characterized Type I (insulin-dependent) diabetic patients with normal (GFR≥75 ml·min -1 ·(1.73 m 2 ) -1 ; n=273), or impaired renal function (GFR <75 ml·min -1 ·(1.73 m 2 ) -1 ; n=116). Results. Patients with microvascular and macrovascular complications showed higher total plasma homocysteine concentrations than those without complications. However, after the data for GFR (main determinant for plasma homocysteine) was adjusted we observed that plasma homocysteine concentrations greater than 8.6 µmol/l in patients with normal GFR are not related to vascular complications, but to hypertension (8.6-11.3 µmol/l: OR 1.9; >11.3 µmol/l: OR 3.7). The risk for coronary heart disease (CHD) was also enhanced by a plasma homocysteine concentration greater than 11.3 µmol/l (OR 5.9). Although the T allele was an independent determinant of plasma homocysteine, the methylenetetrahydrofolate reductase gene polymorphism was neither associated with diabetic vascular complications nor with hypertension. The excess mortality in patients with Type I (insulindependent) diabetes mellitus is related to the development of diabetic nephropathy [1], which is associated with an increasing incidence of CHD, retinopathy and rising blood pressure. Epidemiological studies have shown that the risk and severity of those diabetic microvascular and macrovascular complications are strongly related to the duration of diabetes, poor glycaemic control, and hypertension. However, results of interventional trials indicated that intensified insulin treatment and antihypertensive therapy could not en- Conclusion

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Total plasma homocysteine is associated with hypertension in Type I diabetic patients

et al. 2002

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“…[9][10][11][12][13][14][15][16] Homocysteine promotes oxidant injury to the vascular endothelium, impairs endothelium-dependent vasomotor regulation, and may also alter the coagulant properties of the blood.…”

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confidence: 99%

“…The association between homocysteine and sustained hypertension has been investigated, [9][10][11][12][13][14][15] and it is thought that an interaction between homocysteine and endothelium in hypertensive patients may promote thrombogenesis and atherogenesis, leading to adverse cardiovascular events. 16) To the best of our knowledge, only one study has evaluated homocysteine levels in WCH.…”

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confidence: 99%

<b>Hyperhomocysteinemia</b>

et al. 2005

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SUMMARYThe association between homocysteine and sustained hypertension (HT) has been studied. The aim of this study was to assess homocysteine levels in white coat hypertension (WCH) as an indicator of increased risk in the development of cardiovascular diseases. WCH was defined as clinical hypertension and a daytime ambulatory blood pressure of < 135/85 mmHg. Plasma levels of homocysteine were determined in patients with WCH, hypertension, and normotension (NT). The study group included 100 subjects, 33 with WCH (16 males, 17 females) aged 49.1 ± 1.9; 35 sustained hypertensives (17 males,18 females) aged 48.5 ± 1.7 and 32 normotensive control subjects (15 males, 17 females) aged 48.8 ± 2.2. The subjects were matched for age, gender, and body mass index. Patients with a smoking habit, dyslipidemia, or diabetes mellitus were not included in the study. Homocysteine levels were analyzed by ELISA. Plasma homocysteine levels were significantly higher in the WCH group compared to the controls (12.32 ± 1.07 versus 5.35 ± 1.38 µmol/L; P < 0.001) and the WCH group had significantly lower homocysteine values than the hypertensives (19.03 ± 0.76 µmol/L P < 0.001). Total cholesterol and triglycerides were not different among the groups. There were no statistically significant differences in urinary albumin excretion (UAE) or creatinine clearence between the three groups. Hypertensive retinopathy was observed in the WCH group, but was less severe and less frequent compared to HTs. LVMI was greater in the WCH group compared to the NTs, but significantly less than HTs.The data demonstrate that WCH is associated with high levels of homocysteine. The increase in homocysteine level in WCH is not as high as in SHT. Since an elevated plasma homocysteine level is a strong risk factor for coronary artery disease and there was target organ damage in our WCH group, we conclude that WCH should not be considered to be an innocent trait. (Int Heart J 2005; 46: 245-254)

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