Homocysteine Does Not Predict Development, of Hypertension

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NEW YORK (Reuters Health) Dec 23 - While plasma homocysteine levels

have been associated cross-sectionally with hypertension, they are

not significantly related to hypertension incidence or long-term

blood pressure progression, according to a report in the December

issue of Hypertension.

Several previous studies have linked elevated homocysteine levels to

an increased risk of cardiovascular disease, particularly among

hypertensive individuals, the authors note, but no previous study

has examined prospectively the possible relationship between

baseline plasma homocysteine and occurrence of hypertension.

Dr. Ramachandran S. Vasan with the Framingham Heart Study in

Massachusetts and colleagues used data from participants in the

study to test the hypothesis that hyperhomocysteinemia is related to

the development of hypertension.

In a cohort of 2104 subjects, mean age 57 years, the mean

homocysteine levels at baseline was 10.1 micromoles/L. Over 4 years,

17>1% developed hypertension.

In unadjusted analyses, an increasing incidence of hypertension was

seen with increasing homocysteine levels and with plasma

homocysteine above 14 micromoles/L, the authors report. These

relationships lost statistical significance in multivariable models.

Similarly, increasing homocysteine values were associated with

increased odds of blood pressure progression in unadjusted analyses,

the report indicates, but these associations also lost statistical

significance after adjustment for age and sex in multivariable

models.

Moreover, plasma homocysteine was not related to changes in systolic

blood pressure in any of the models, the researchers note, and an

inverse association of plasma homocysteine to change in diastolic

blood pressure was statistically insignificant after adjustment for

other variables.

" In light of our observations, " the investigators write, " it is

likely that the increased plasma homocysteine levels previously

reported in hypertensive persons are concomitant rather than a

precursor of hypertension. "

" Our longitudinal observations do not support the hypothesis that

plasma homocysteine is causally related to elevated blood pressure, "

the authors conclude. " Additional prospective investigations are

warranted to confirm these findings. "

Hypertension 2003;42:1100-1105.