[A prospective study on the association of plasma homocysteine level with stroke in hypertensive patients].

OBJECTIVE

To analyze the association between homocysteine (Hcy) and stroke in hypertensive patients.

METHODS

This was a prospective cohort study conducted in 60 communities in Nanshan District, Shenzhen. Totally 5 488 patients with hypertension were included at baseline survey and followed for an average of 2.7 years. At the end of follow-up, 327 (5.96%) subjects were missing with unknown reasons. Hcy was detected by enzymatic cycling method. Head CT, MRI, cerebral angiography and transcranial Doppler ultrasound were performed in the patients. Stroke was defined based on the International Classification of Diseases (ICD10 coding I60-I64).

RESULTS

After an average of 2.7-year follow-up, 197 developed new stroke. The incidence rate was 3.82%. Subjects whose Hcy levels were within the highest quartile (Q4) had higher risk to develop stroke compared with those whose Hey levels were within the lowest quartile (Q1). The HR (95% CI) were 7.4 (3.2-13.2) in total with 7.5(3.0-19.5) in men and 7.7 (2.7-22.1) in women after adjustment of age, sex, education, smoking, alcohol drinking, and BMI, physical activity, diabetes, depression, family history of stroke or coronary heart disease, years of hypertension, antihypertensive drugs, folic acid, systolic blood pressure, TC, glucose and TG. For every 5 µmol/L increase in Hcy, the HR (95% CI) of stroke increased 1.15-fold (1.09-1.21) in total subjects with 1.15 (1.08-1.21) in men and 1.19 (1.04-1.35) in women, respectively. No significant interactions on stroke could be found between Hcy and the above stratified factors.

CONCLUSION

Elevated Hcy levels were associated with stroke in hypertensive patients.