O. Nygard et al., TOTAL PLASMA HOMOCYSTEINE AND CARDIOVASCULAR RISK PROFILE - THE HORDALAND HOMOCYSTEINE STUDY, JAMA, the journal of the American Medical Association, 274(19), 1995, pp. 1526-1533
Objective.-To estimate the relations between established cardiovascula
r risk factors and total homocysteine (tHcy) in plasma. Design.-Health
examination survey by the Norwegian Health Screening Service in 1992
and 1993. Setting.-General community, Hordaland County of Western Norw
ay. Participants.-A total of 7591 men and 8585 women, 40 to 67 years o
f age, with no history of hypertension, diabetes, coronary heart disea
se, or cerebrovascular disease were included. Main Outcome Measure.-Pl
asma tHcy level. Results.-The level of plasma tHcy was higher in men t
han in women and increased with age. In subjects 40 to 42 years old, g
eometric means were 10.8 mu mol/L for 5918 men and 9.1 mu mol/L for 63
48 women. At age 65 to 67 years, the corresponding tHcy values were 12
.3 mu mol/L (1386 men) and 11.0 mu mol/L (1932 women). Plasma tHcy lev
el increased markedly with the daily number of cigarettes smoked in al
l age groups. Its relation to smoking was particularly strong in women
. The combined effect of age, sex, and smoking was striking. Heavy-smo
king men aged 65 to 67 years had a mean tHcy level 4.8 mu mol/L higher
than never-smoking women aged 40 to 42 years. Plasma tHcy level also
was positively related to total cholesterol level, blood pressure, and
heart rate and inversely related to physical activity. The relations
were not substantially changed by multivariate adjustment, including i
ntake of vitamin supplements, fruits, and vegetables. Conclusions.-Ele
vated plasma tHcy level was associated with major components of the ca
rdiovascular risk profile, ie, male sex, old age, smoking, high blood
pressure, elevated cholesterol level, and lack of exercise. These find
ings should influence future studies on the etiology and pathogenesis
of cardiovascular disease.