Association Of Total Homocysteine With Blood Pressure In Adults Over 35 Years Old

Objectives Our subject aimed to evaluate the level of total homocysteine(tHcy),blood pressure and the prevalence of hypertension in the adults over 35 years old of Lianyungang.Additionally,we aimed to investigate the relation of total homocysteine(tHcy)concentrations with systolic blood pressure,diastolic blood pressure levels and hypertension among this population,and further examine the possible modifiers in the association.Methods This project conducted epidemiological investigation in 21 communities in Lianyungang,Jiangsu Province from June to September,2016.We recruited over 35 years old participants from the communities and through a standardized epidemiological questionnaire(gender,age,lifestyle,medical and medication history),physical examination(height,weight and blood pressure)and laboratory tests to obtain the relevant information of the participants.Multivariate linear regression was performed to assess the relationship between total homocysteine concentrations and blood pressure levels,and the association between homocysteine levels and the prevalence of hypertension was investigated by multivariate logistic regression.Results A total of 26,648 people were enrolled in this study,including 9,262(34.8%)males and 17,386(65.2%)females.The overall mean age was 57.9 ± 10.3 years with a total homocysteine level of 13.2 ± 6.1 ?mol / L,systolic blood pressure of 129.2 ± 16.3 mmHg,diastolic blood pressures of 82.2 ± 12.2 mmHg and prevalence of hypertension of 32.0% in the total population.There were 3689(75.7%)of those with total homocysteine levels ? 10 ?mol / L and 6476(24.3%)?15 ?mol / L.Males with higher total homocysteine levels,and higher systolic and diastolic blood pressure than women.Overall,there was a positive association between tHcy concentrations and systolic blood pressure(per 5 ?mol/L tHcy increase: Adjusted ?: 0.45 mmHg,95%CI: 0.29-0.61),or diastolic blood pressure levels(per 5 ?mol/L tHcy increase: Adjusted ?: 0.47 mmHg,95%CI: 0.35-0.59).Compared to participants with tHcy <10 ?mol/L,significantly higher systolic blood pressure levels were found in those with tHcy concentrations of 10-<15(Adjusted ?: 0.80 mmHg,95%CI: 0.32-1.28)and ?15 ?mol/L(Adjusted ?: 1.79 mmHg,95%CI: 1.20-2.37,P for trend<0.001).Consistently,significantly higher diastolic blood pressure levels were found in participants with tHcy concentrations of 10-<15(Adjusted ?: 0.86 mmHg,95%CI: 0.49-1.22)and ?15 ?mol/L(Adjusted ?: 2.01 mmHg,95%CI: 1.57-2.46,P for trend<0.001),respectively as compared to those with <10 ?mol/L.Additionally,significantly higher risk of hypertension were found in population with tHcy concentrations of 10-<15(Adjusted OR: 1.12,95%CI: 1.04-1.21,)and ?15 ?mol/L(Adjusted OR: 1.32,95%CI: 1.21-1.44,P for trend<0.001),respectively as compared to those with <10 ?mol/L.Similar results was observed in quartiles of total homocysteine.Furthermore,a stronger association between tHcy and systolic blood pressure(P for interaction=0.009),diastolic blood pressure(P for interaction=0.067)and the prevalence of hypertension(P for interaction=0.064)was found in current alcohol drinkers.Conclusion The level of homocysteine in the population is generally high.Serum tHcy concentrations were positively associated with blood pressure levels and the prevalence of hypertension in the population.In addition,alcohol was an important modifiers and the association was stronger in current alcohol drinkers.Therefore,taking effective measures to reduce the level of tHcy in the adult population may be one of the important ways to control blood pressure.