Is homocysteine an independent predictor of hypertension? A case-control study in an elderly population

Patients with hypertension and elevated homocysteine levels have a higher prevalence of risk factors for cardiovascular diseases (CVD) than individuals without either hypertension or elevated homocysteine levels, but the independence of homocysteine as a predictor of hypertension and vice-versa is controversial. This study was to explore the independence of hypertension and homocysteine (HCY) associations using a case-control study design based on a hospital in China. A case-control study was performed using 230 randomly selected 65-year-old and older inpatients with hypertension (cases) and 230 age and sex matched non-hypertensive controls. All participants were assessed for fasting triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), blood urea nitrogen (BUN), creatinine (CR), uric acid (UA), C-reactive protein (CRP), fasting glucose (BS), aspartate aminotransferase (AST) and body mass index (BMI). Data analysis was performed using conditional logistic regression. Compared to patients with hypertension, HCY, TG, TC, HDL, LDL, BUN, UA, CRP, BS and BMI were worse than controls. In multivariate analysis HCY (OR=1.22, P<0.001), BUN (OR=1.25, P=0.03) and CRP (OR=1.25, P=0.02) were independent predictors of hypertension. Amongst all subjects (cases and controls), the presence of elevated homocysteine was independently associated with hypertension (OR=9.93, P<0.001), TG (OR=3.56, P<0.001), LDL (OR=1.64, P=0.01), CRP (OR=1.50, P<0.001), BS (OR=0.75, P=0.02) and BMI (OR=1.14, P=0.001). Elevated homocysteine and hypertension are each independent predictors of each other. Hypertension is also independently associated with BUN and CRP, while elevated homocysteine is independently associated with TG, TC, LDL, CRP, BS and BMI.