Correlative Study On Relationship Between Serum Homocysteine Levels In Patients With Hypertension And Blood Pressure Variability

BackgroundsHypertension is the most common cardiovascular disease. It is also a major publichealth problem in the world. In China, the presence of hypertension,"three high" isthat high prevalence, high mortality and high morbidity.Also the "three lows" is thatlow awareness, low treatment and low control rates characteristics. Presently, Chinahas become one of the most seriously dangerous of hypertension countries affected inthe world. According to the2002National Nutrition and Health Survey data，it showsthat adult prevalence rate is18.8percent in China. There are about160millionpatients with hypertension. The task which we face how to prevent hypertension isvery difficult. In addition, the hypertension prevalence rate is different between thegenders and urban-rural in China. The prevalence of hypertension is proportional toage. The prevalence rate of women is lower than men when pre-menopausal. Aftermenopause it is higher than men. In economically backward regions the prevalencerate is lower and in the economically developed regions it is higher. There is somegenetic basis about hypertension. The blood pressure of immediate family issignificantly correlated. There are some differences between different rates and ethnic.According to the epidemiological investigation, it shows that stroke is a major threatto the health of us. A research shows that the incidence of coronary heart disease ofstroke is multiple. The main risk factor for stroke is hypertension. Therefore, activecontrol of hypertension is an important measure to prevent stroke.According to epidemiological and clinical research data of domestic and abroad, itis defined as a high homocysteine (Hyperhomocysteinemia, HHcy) when thehomocysteine (Homocysteine, Hcy) is over10umol/l. Hypertension with elevated plasma Hcy is defined as H type hypertension. H type hypertension is an importantrisk factor for stroke. In order to reduce the stroke risk we should concern about theimpact of HHcy on stroke and do something for screening and intervention as early aspossible on H hypertension. The initiative has important implications for the higherincidence of stroke in our country. It has been reported that most of the patients withhypertension associated with elevated plasma Hcy. The higher blood pressurevariability increased target organ damage. However, the study about the correlationbetween Hcy and blood pressure variability with the patients of hypertension is less.This research aims to explore the relationship between Hcy and BPV with the patientsof hypertension, to provide reference for preventing target organ damage ofhypertension.ObjectiveTo observe the changes of serum homocysteine levels in patients with hypertensionand blood pressure variability, and to investigate its relationship with hypertension.Methods50patients with essential hypertension in the Forth Affiliated Hospital ofZhengzhou University, Department of Cardiology were enrolled in this study fromMay2011to December2012. And the above patients were diagnosed of essentialhypertension according to the revised2010edition of "the Chinese HypertensionPrevention Guidelines".50cases of healthy volunteers as the control group. The levelsof serum homocysteine(Hcy)，serum biochemistry and24hour ambulatory bloodpressure monitoring were detected in the all cases. Then calculate BMI (body massindex, BMI). Two groups were compared with serum Hcy levels and blood pressurevariability，and to analyze the correlation between serum Hcy with hypertension.Results1. The serum Hcy level in patients with hypertension was significantly higher thanthat of healthy cases, the difference was statistically significant (P＜0.001).2. The24hSSD,24hDSD,dSSD,dDSD,nSSD,nDSD,24hDCV,dSCV and nSCV ofpatients with hypertension were higher than those of healthy cases, and the difference has obvious statistical significant(P＜0.05); but the difference of the24hSCV,dDCVand nDCV between two groups was not statistically significant(P＞0.05).3. The24hSSD,dSSD,dDSD,nSSD,nDSD,24hSCV,dSCV and nSCV ofhypertension with elevated plasma Hcy were higher than hypertension with thenormal Hcy group, the difference was statistically significant (p＜0.05); but there wasno significant difference of the24hDSD,24hDCV,dDCV and nDCV between twogroups (P＞0.05).4. Correlation analysis between Hcy and BPV showed that there was a positivecorrelation between serum Hcy levels and24hSSD, dSSD, dDSD, nDSD,24hSCV,dSCV, dDCV.Conclusions1. The study showed that the blood pressure variability of higher Hcy group washigher than the normal Hcy group; HHcy may increase blood pressure variability.2. The study showed that there was a positive correlation between Hcy levels andblood pressure variability, and both of them were significantly increased in patientswith hypertension.