Original Article

Spinal Cord (2006) 44, 474–479. doi:10.1038/sj.sc.3101873; published online 6 December 2005

Homocysteine and hypertension in persons with spinal cord injury

M Y Lee1, J Myers2,3, J Abella2, V F Froelicher2,3, I Perkash1,4 and B J Kiratli1

  1. 1Spinal Cord Injury Service, Department of Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
  2. 2Cardiology Division, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
  3. 3Department of Cardiology, Stanford University School of Medicine, Palo Alto, CA, USA
  4. 4Department of Urology, Stanford University School of Medicine, Palo Alto, CA, USA

Correspondence: MY Lee, Palo Alto Health Care System, Building 7, Room C-104 (128), 3801 Miranda Avenue, Palo Alto, CA 94304, USA

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Abstract

Study design:

 

Cross-sectional analysis of a convenience sample of locally recruited participants, including both patients and volunteers.

Objectives:

 

To determine whether there is an association between plasma homocysteine and hypertension in persons with spinal cord injury (SCI).

Setting:

 

Spinal Cord Injury Service of the Veterans Affairs Palo Alto Medical Center (California, United States of America).

Methods:

 

The incidence of hypertension, dyslipidemia, insulin resistance, and the presence of metabolic syndrome were determined in 168 individuals with SCI (mean age 50.2plusminus12.8 years). Fasting lipids, insulin, glucose, plasma homocysteine, and anthropometric data was gathered for each subject.

Results:

 

Blood pressure values (P<0.001) and mean arterial pressure (P<0.05) increased with higher plasma homocysteine levels. Homocysteine values were also significantly greater among individuals with hypertension compared with those who were normotensive or prehypertensive (P<0.0001). There was an inverse relationship between plasma homocysteine levels and glomerular filtration rate and effective renal plasma flow (P<0.05).

Conclusions:

 

Plasma homocysteine levels are elevated in persons with SCI who have hypertension and inversely related to renal function, which suggests that renal dysfunction may be a link between homocysteine and hypertension in persons with SCI.

Sponsorship:

 

Funded by the VA Rehabilitation Research and Development Service, Merit Review Grant #B2549R.

Keywords:

homocysteine, hypertension, renal function, spinal cord injury

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