Relationship Of Morning Blood Pressure Surge With Plasma Homocysteine And MTHFR In Patients With Essential Hypertension

Aim:To investigate the relation between plasma homocysteine(HCY),methylenetetrahydrofolate reductase(MTHFR)gene polymorphisms and Morning Blood Pressure Surge(MBPS)in patients with Essential Hypertension.Methods:122 patients with Essential Hypertension were studied.According to ambulatory blood pressure monitoring(ABPM),the patients were divided into 2 groups: MBPS group,n=70 and Non-MBPS group,n=52.The blood levels of urea nitrogen(BUN),creatinine(Cr),urinary trace albumin,serum uric acid,plasma Hcy were examined and compared between 2 groups.Polymorphisms of the MTHFR gene were measured by polymerase chain reaction were compared between 2 groups.Results:The frequencies of TT genotype(25.7% VS 9.6%)were significantly higher in the MBPS group than Non-MBPS group(p < 0.05).Plasma Hcy levels was significantly higher in the MBPS group than Non-MBPS group(20.09±3.12μmol/L VS13.25±3.00μmol/L,P<0.01).The Hcy concentration was significantly higher in TT genotype than CC and CT genotypes(25.11±2.83 μmol/L VS12.68 ±1.36μmol/L,P<0.05;25.11±2.83μmol/L VS 13.64±2.20 μmol/L,P<0.05)in the MBPS group.The Hcy concentration was also significantly higher in TT genotype than CC and CT genotypes(18.00±1.10 μmol/L VS 12.30±1.34μmol/L,P<0.05;18.00±1.10μmol/L VS9.89±1.52μmol/L,P<0.05)in the Non-MBPS group.Logistic regression analysis adjusted for gender,age,smoking,and drinking,hyperlipidemia and other risk factors,plasma homocysteine levels and MTHFRgene TT genotype remained an independent risk factors for Morning Blood Pressure Surge(β=0.57,OR = 1.76,95% CI = 1.01 5.43,P< 0.05;β=0.65,OR 1.92,95%CI=1.31-9.48 P<0.05).Conclusions:MTHFR C677 T gene polymorphism was significantly correlated with morning peakhypertension,MTHFR C677 T gene polymorphism was closely related to plasma Hcy level,and TT homozygous mutation significantly increased Hcy level.