Homocysteine, Ischemic Stroke, and Coronary Heart Disease in Hypertensive Patients A Population-Based, Prospective Cohort Study

被引：118

作者：

Han, Liyuan ^{[1
]}

Wu, Qunhong ^{[2
]}

Wang, Changyi ^{[3
]}

Hao, Yanhua ^{[2
]}

Zhao, Jinshun ^{[1
]}

Zhang, Lina ^{[1
]}

Fan, Rui ^{[1
]}

Liu, Yanfen ^{[1
]}

Li, Runhua ^{[1
]}

Chen, Zhongwei ^{[3
]}

Zhang, Tao ^{[3
]}

Chen, Sihan ^{[3
]}

Ma, Jianping ^{[3
]}

Liu, Shengyuan ^{[3
]}

Peng, Xiaolin ^{[3
]}

Duan, Shiwei ^{[1
]}

机构：

[1] Ningbo Univ, Sch Med, Zhejiang Prov Key Lab Pathophysiol, Dept Prevent Med, Ningbo 315211, Zhejiang, Peoples R China

[2] Harbin Med Univ, Sch Publ Hlth, Dept Social Med, Harbin 150081, Peoples R China

[3] Shenzhen Nanshan Ctr Chron Dis Control, Dept Chron Dis Prevent & Control, Shenzhen, Peoples R China

来源：

STROKE | 2015年 / 46卷 / 07期

基金：

中国国家自然科学基金;

关键词：

coronary heart disease; homocysteine; hypertension; ischemia; stroke; B-VITAMIN THERAPY; PLASMA HOMOCYSTEINE; RISK-FACTOR; FOLATE; SUPPLEMENTATION; METAANALYSIS; TRANSITION; NUTRITION; FAILURE; MTHFR;

D O I：

10.1161/STROKEAHA.115.009111

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose Total homocysteine level (tHcy) is a risk factor of ischemic stroke (IS) and coronary heart disease. However, the results are conflicting and mainly focused on healthy individuals in developed countries. Methods A prospective, population-based cohort study was conducted among 5935 participants from 60 communities in the city of Shenzhen, China. A Cox regression analysis was applied to evaluate the contribution of tHcy to the risk of IS and coronary heart disease. The effect of folic acid supplementation on tHcy levels was also evaluated among 501 patients with essential hypertension, who received an average of 2.5 years of folic acid supplementation. Results After adjustment for confounding factors, the hazard ratios (95% confidence intervals) of IS caused by hyperhomocysteinemia were 2.18 (1.65-2.89), 2.40 (1.56-3.67), and 2.73 (1.83-4.08) in the total, male, and female participants, respectively. Compared with normal levels of tHcy (<15 mol/L), the hazard ratios (95% confidence intervals) for IS in the highest tHcy category (30 mol/L) were 4.96 (3.03-8.12), 6.11 (3.44-10.85), and 1.84 (0.52-6.46) in the total, males, and females participants, respectively. However, we did not observe a significant relationship between tHcy and the risk of coronary heart disease. The 2.5 years of folic acid supplementation reduced tHcy levels by 6.7 mol/L (27.92%) in patients with essential hypertension. Conclusions Hyperhomocysteinemia in Chinese hypertensive patients is significantly associated with IS risk but not coronary heart disease susceptibility, and folic acid supplementation can efficiently reduce tHcy levels.

引用

页码：1777 / 1786

页数：10

共 49 条

[1] Asymmetric Dimethylarginine: a Novel Cardiovascular Risk Factor in End-stage Renal Disease [J].