TY - JOUR
T1 - High homocysteine levels are independently related to isolated systolic hypertension in older adults
AU - Sutton-Tyrrell, Kim
AU - Bostom, Andrew
AU - Selhub, Jacob
AU - Zeigler-Johnson, Charnita
PY - 1997/9/16
Y1 - 1997/9/16
N2 - Background: The association between homocysteine and isolated systolic hypertension in older adults was evaluated using a case-control design, and the relationship between homocysteine and clinical or subclinical atherosclerosis was explored. Methods and Results: Cases were 179 adults ≤60 years with a systolic blood pressure of ≤160 mm Hg and diastolic blood pressure <90 mm Hg. One hundred seventy-one control subjects had the same criteria except systolic blood pressures were <160 mm Hg. All had normal creatinine levels. Homocysteine levels were performed on fasting blood samples that had been stored at -70°C. Atherosclerosis was defined as either a history of clinical disease, an internal carotid stenosis of ≤40% by duplex scan, or an ankle/arm pressure ratio of <0.9. The median homocysteine value was 11.5 μmol/L for cases and 9.9 for control subjects (P<.001). After control for potential confounders, homocysteine remained significantly associated with systolic hypertension (P=.019). For the hypertensive group, there was no apparent association between level of homocysteine and prevalence of atherosclerosis. However, among the normotensive group, the prevalence of atherosclerosis went from 22% in the lowest quintile of homocysteine values to 53% in the fifth quintile, with an odds ratio of 4.1 (fifth quintile in comparison to the first, P<.05). After adjustment for age, sex, systolic blood pressure, cholesterol, and smoking, this odds ratio increased to 6.4 (P<.01). Conclusions: Elevated levels of homocysteine may be related to the cause of isolated systolic hypertension in some individuals. In normotensive older adults, homocysteine ap pears to be an independent risk factor for atherosclerosis.
AB - Background: The association between homocysteine and isolated systolic hypertension in older adults was evaluated using a case-control design, and the relationship between homocysteine and clinical or subclinical atherosclerosis was explored. Methods and Results: Cases were 179 adults ≤60 years with a systolic blood pressure of ≤160 mm Hg and diastolic blood pressure <90 mm Hg. One hundred seventy-one control subjects had the same criteria except systolic blood pressures were <160 mm Hg. All had normal creatinine levels. Homocysteine levels were performed on fasting blood samples that had been stored at -70°C. Atherosclerosis was defined as either a history of clinical disease, an internal carotid stenosis of ≤40% by duplex scan, or an ankle/arm pressure ratio of <0.9. The median homocysteine value was 11.5 μmol/L for cases and 9.9 for control subjects (P<.001). After control for potential confounders, homocysteine remained significantly associated with systolic hypertension (P=.019). For the hypertensive group, there was no apparent association between level of homocysteine and prevalence of atherosclerosis. However, among the normotensive group, the prevalence of atherosclerosis went from 22% in the lowest quintile of homocysteine values to 53% in the fifth quintile, with an odds ratio of 4.1 (fifth quintile in comparison to the first, P<.05). After adjustment for age, sex, systolic blood pressure, cholesterol, and smoking, this odds ratio increased to 6.4 (P<.01). Conclusions: Elevated levels of homocysteine may be related to the cause of isolated systolic hypertension in some individuals. In normotensive older adults, homocysteine ap pears to be an independent risk factor for atherosclerosis.
KW - Aging
KW - Atherosclerosis
KW - Elasticity
KW - Hypertension
KW - Peripheral vascular disease
UR - http://www.scopus.com/inward/record.url?scp=0030866856&partnerID=8YFLogxK
U2 - 10.1161/01.CIR.96.6.1745
DO - 10.1161/01.CIR.96.6.1745
M3 - Article
SN - 0009-7322
VL - 96
SP - 1745
EP - 1749
JO - Circulation
JF - Circulation
IS - 6
ER -