Homocysteine levels in hypertensive patients with a history of cardiac or cerebral atherothrombotic events

Hypertension is one of the most important risk factors for cardiovascular m orbidity and mortality. Recently it has been suggested that the amino acid homocysteine contributes to this process. This study evaluates whether elev ated plasma levels of homocysteine in hypertensive patients are associated with increased risk for cardiovascular events. Fifty hypertensive patients with a documented history of cerebral or cardia c events were age and gender matched to 50 hypertensive patients with no ev idence of any cerebral or cardiac event. Demographic details, duration of h ypertension, presence of other risk factors, and use of antihypertensive me dications were recorded for each patient. Plasma levels of homocysteine wer e measured by high-performance liquid chromatography technology. The two groups had similar demographic parameters, with a mean age of 64.6 +/- 9.4 years. Patients with cardiovascular events were more likely to be p ast smokers and to have been treated with calcium antagonists, aspirin, and nitrates. Homocysteine levels were 12.1 +/- 5.8 mu mol/L in those with doc umented cardiovascular disease and 11.1 +/- 4.7 mu mol/L in those without ( P = NS). Levels of plasma homocysteine were higher in those with hyperchole sterolemia (P = .03) and in smokers, and tended to be lower in those who us ed beta-blockers, angiotensin converting enzyme (ACE) inhibitors, diuretics , and nitrates. Thus, hyperhomocysteinemia is not a feature of hypertensive patients with a therothrombotic events and there is no support for additive or synergistic effects between these two independent risk factors. (C) 1999 American Journ al of Hypertension, Ltd.