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Prevention of Non Communicable Diseases

Prevalence of hyperhomocysteinemia (HHcy) and its major determinants among hypertensive patients over 35 years of age

European Journal of Clinical Nutrition volume 76, pages 616–623 (2022)Cite this article

Subjects

Abstract

Objective

Hyperhomocysteinemia (HHcy) and hypertension are associated with cardiovascular events. However, effects of Hcy-lowing interventions on cardiovascular outcome were conflicting. Serum folate level was proposed to be a possible determinant of efficacy of extra folate supplementation on cardiovascular outcome. The aims of the present study were to describe representative information on the levels of serum homocysteine and folate in hypertensive patients, and to explore the major determinants of HHcy.

Methods

11,007 participants with hypertension were analyzed in this cross-sectional study. Blood pressure and serum levels of biochemical indicators were measured. Multivariate logistic regression model was used to assess the associated factors of HHcy.

Results

Geometric mean of serum total homocysteine was 14.1 (95% CI: 13.9, 14.4) μmol/L and prevalence of HHcy was 36.1 (95% CI: 34.0, 38.1) % in hypertensive patients. HHcy was strongly associated with factors including male sex, older age, elevated serum creatinine (SCr), lower serum folate and vitamin B12, and uncontrolled blood pressure in hypertensive patients. Elevated SCr attributed to HHcy with the etiologic fraction of 0.29. The change of the odds ratio of HHcy associated with folate was significantly higher in patients with elevated SCr compared with that of patients with normal SCr.

Conclusion

The results suggested the protection of female sex and higher levels of folate and vitamin B12 from HHcy and attribution of older age and elevated SCr to HHcy. Restoring renal function deserved attention for hypertensive patients to benefit from Hcy-lowing measures.

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Fig. 1: Profile of participants.
Fig. 2: Comparison of GM of tHcy between SCr normal and elevated hypertensive patients across quintiles.

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Data availability

Data will be available from the corresponding author upon request.

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Acknowledgements

This work was supported by Shanghai Municipal Commission of Health and Family Planning grant 20134129, Shanghai Municipal Health Commission (GWV-7, GWV-10.1-XK05, and GWV-10.1-XK16), and the funding of Innovative research team of high-level local universities in Shanghai and a key laboratory program of the Education Commission of Shanghai Municipality (ZDSYS14005). Shanghai Municipal Center for Disease Control and Prevention also facilitated this research. We greatly appreciate the support of the District Health and Family Planning Commission and the district centers of Disease Control and Prevention.

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Author notes

  1. These authors contributed equally: Minna Cheng and Hong Xue.

Authors and Affiliations

  1. Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China

    Minna Cheng, Xinjian Li, Qinghua Yan, Yan Shi & Chen Fu

  2. Shanghai Key Laboratory of Bioactive Small Molecules and Shanghai Key Laboratory of Clinical Geriatric Medicine, Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, China

    Hong Xue

  3. Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    Dingliang Zhu & Yan Wang

  4. National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China

    Yan Shi

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Contributions

MC designed the study. MC and HX wrote the manuscript. XL and QY did the data analysis and interpretation. DZ and YW provided suggestions to the study. YS and CF supervised the study and revised the manuscript.

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Correspondence to Minna Cheng, Yan Shi or Chen Fu.

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Cheng, M., Xue, H., Li, X. et al. Prevalence of hyperhomocysteinemia (HHcy) and its major determinants among hypertensive patients over 35 years of age. Eur J Clin Nutr 76, 616–623 (2022). https://doi.org/10.1038/s41430-021-00983-6

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