Abstract
Hyperhomocysteinemia has been reported to be associated with both vascular structure alteration and increased cardiovascular risk. This study examined whether hyperhomocysteinemia causes increased systemic arterial stiffness, thereby enhancing blood pressure response to stress in hypertensive patients. In 50 treated hypertensive patients, we studied brachial-ankle pulse wave velocity (PWV), a new measure for arterial stiffness, blood pressure response to stress, and blood pressure recovery after stress. Autonomic nervous activities were examined by spectral analysis of blood pressure and RR interval variabilities. Total plasma homocysteine and neurohumoral parameters were determined from fasting blood. Brachial-ankle PWV correlated with age (r=0.64, p<0.001), plasma homocysteine concentration (r=0.35, p<0.05), and systolic blood pressure (SBP) (r=0.62, p<0.001). Higher plasma homocysteine concentration was independently associated with greater brachial-ankle PWV (β=0.388, p=0.01). We classified the subjects into high homocysteine (7.3 nmol/ml or over) and low homocysteine (7.2 nmol/ml or below) groups. Baseline SBP, plasma renin activity, aldosterone, and norepinephrine concentrations were similar between the two groups. However, the SBP values during stress and the recovery periods were higher in the high homocysteine group than the low homocysteine group even after adjusting for sex and age. The behavior of sympathetic vasomotor activity did not differ between the two groups. These data suggest that higher plasma homocysteine concentration is associated with increased systemic arterial stiffness, which may enhance blood pressure reactivity to stress in hypertensive patients.
Similar content being viewed by others
Article PDF
References
Boushey C, Beresford S, Omenn G, Motulsky A : A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA 1995; 274: 1049–1057.
Refsum H, Ueland PM, Nygard O, Vollset SE : Homocysteine and cardiovascular disease. Annu Rev Med 1998; 49: 31–62.
Nygard O, Nordrehaug JE, Refsum H, Ueland PM, Farstad M, Vollset SE : Plasma homocysteine levels and mortality in patients with coronary artery disease. N Engl J Med 1997; 337: 230–236.
Malinow MR, Nieto FJ, Szklo M, Chambless LE, Bond G : Carotid artery intimal-medial wall thickening and plasma homocysteine in asymptomatic adults. Circulation 1993; 87: 1107–1113.
Montalescot G, Ankri A, Chadefaux-Vekemans B, et al: Plasma homocysteine and the extent of atherosclerosis in patients with coronary artery disease. Int J Cardiol 1997; 60: 295–300.
Welch GN, Loscalzo J : Homocysteine and atherothrombosis. N Engl J Med 1998; 338: 1042–1050.
Tawakol A, Omland T, Gerhard M, Wu JT, Creager MA : Hyperhomocyst(e)inemia is associated with impaired endothelium-dependant vasodilatation in humans. Circulation 1997; 95: 1119–1121.
Charpiot P, Bescond A, Augier T, et al: Hyperhomocysteinemia induces elastolysis in minipig arteries: structural consequences, arterial site specificity and effect of captopril-hydrochlorothiazide. Matrix Biol 1998; 17: 559–574.
Bortolotto LA, Safar ME, Billaud E, et al: Plasma homocysteine, aortic stiffness, and renal function in hypertensive patients. Hypertension 1999; 34: 837–842.
Oron-Herman M, Rosenthal T, Sela BA : Hyperhomocysteinemia as a component of syndrome X. Metabolism 2003; 52: 1491–1495.
Kuroda S, Uzu T, Fujii T, et al: Role of insulin resistance in the genesis of sodium sensitivity in essential hypertension. J Hum Hypertens 1999; 13: 257–262.
Nygard O, Vollset SE, Refsum H, et al: Total plasma homocysteine and cardiovascular risk profile. The Hordaland Homocysteine Study. JAMA 1995; 274: 1526–1533.
Lim U, Cassano PA : Homocysteine and blood pressure in the Third National Health and Nutrition Examination Survey, 1988–1994. Am J Epidemiol 2002; 156: 1105–1113.
Matthews KA, Owens JF, Kuller LH, Sutton-Tyrrell K, Lassila HC, Wolfson SK : Stress-induced pulse pressure change predicts women's carotid atherosclerosis. Stroke 1998; 29: 1525–1530.
Munakata M, Hiraizumi T, Nunokawa T, et al: Type A behavior is associated with an increased risk of left ventricular hypertrophy in male patients with essential hypertension. J Hypertens 1999; 17: 115–120.
Steptoe A, Marmot M : Impaired cardiovascular recovery following stress predicts 3-year increases in blood pressure. J Hypertens 2005; 23: 529–536.
Munakata M, Ito N, Nunokawa T, Yoshinaga K : Utility of automated brachial ankle pulse wave velocity measurements in hypertensive patients. Am J Hypertens 2003; 16: 653–657.
Munakata M, Sakuraba J, Tayama J, et al: Higher brachial-ankle pulse wave velocity is associated with more advanced carotid atherosclerosis in end-stage renal disease. Hypertens Res 2005; 28: 9–14.
Munakata M, Hiraizumi T, Tomiie T, et al: Psychobehavioral factors involved in the isolated office hypertension: comparison with stress-induced hypertension. J Hypertens 1998; 16: 419–422.
Munakata M, Saito Y, Nunokawa T, Ito N, Fukudo S, Yoshinaga K : Clinical significance of blood pressure response triggered by a doctor's visit in patients with essential hypertension. Hypertens Res 2002; 25: 343–349.
Munakata M, Aihara A, Imai Y, Noshiro T, Ito S, Yoshinaga K : Altered sympathetic and vagal modulations of the cardiovascular system in patients with pheochromocytoma: their relations to orthostatic hypotension. Am J Hypertens 1999; 12: 572–580.
Munakata M, Kameyama J, Nunokawa T, Ito N, Yoshinaga K : Altered Mayer wave and baroreflex profiles in high spinal cord injury. Am J Hypertens 2001; 14: 141–148.
Munakata M, Aihara A, Imai Y, Omata K, Abe K, Yoshinaga K : Increased gain in baroreceptor-heart rate reflex in patients with primary aldosteronism. J Hypertens 1995; 13: 1648–1653.
Neves MF, Endemann D, Amiri F, et al: Small artery mechanics in hyperhomocysteinemic mice: effects of angiotensin II. J Hypertens 2004; 22: 959–966.
Kario K, McEwen BS, Pickering TG : Disasters and the heart: a review of the effects of earthquake-induced stress on cardiovascular disease. Hypertens Res 2003; 26: 355–367.
Kikuya M, Hozawa A, Ohokubo T, et al: Prognostic significance of blood pressure and heart rate variabilities: the Ohasama study. Hypetension 2000; 36: 901–906.
Kanemaru A, Kanemaru K, Kuwajima I : The effects of short-term blood pressure variability and nighttime blood pressure levels on cognitive function. Hypertens Res 2001; 24: 19–24.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tayama, J., Munakata, M., Yoshinaga, K. et al. Higher Plasma Homocysteine Concentration Is Associated with More Advanced Systemic Arterial Stiffness and Greater Blood Pressure Response to Stress in Hypertensive Patients. Hypertens Res 29, 403–409 (2006). https://doi.org/10.1291/hypres.29.403
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1291/hypres.29.403
Keywords
This article is cited by
-
Prevalence and risk factors of hypertension in acclimatized lowlanders staying at high altitude for different durations
Journal of Human Hypertension (2018)
-
Black tea protects against hypertension-associated endothelial dysfunction through alleviation of endoplasmic reticulum stress
Scientific Reports (2015)
-
The factors that affect plasma homocysteine levels, pulse wave velocity and their relationship with cardiovascular disease indicators in peritoneal dialysis patients
International Urology and Nephrology (2010)
-
Association of arterial stiffness with HbA1c in 1,000 type 2 diabetic patients with or without hypertension
Endocrine (2009)