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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #167783
Title: PLASMA HOMOCYSTEINE, HYPERTENSION INCIDENCE AND BLOOD PRESSURE TRACKING: THE FRAMINGHAM HEART STUDY

Author
item SUNDSTROM, JOHAN - FRAMINGHAM HEART STUDY
item SULLIVAN, LISA - BOSTON UNIVERSITY
item D'AGOSTINO, RALPH - BOSTON UNIVERSITY
item JACQUES, PAUL - TUFTS/HNRCA
item SELHUB, JACOB - TUFTS/HNRCA
item ROSENBERG, IRWIN - TUFTS/HNRCA
item WILSON, PETER - FRAMINGHAM HEART STUDY
item LEVY, DANIEL - FRAMINGHAM HEART STUDY
item VASAN, RAMACHANDRAN - BOSTON UNIVERSITY

Submitted to: Hypertension
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/7/2003
Publication Date: 12/1/2003
Citation: Sundstrom, J., Sullivan, L., D'Agostino, R.B., Jacques, P.F., Selhub, J., Rosenberg, I.H., Wilson, P.W., Levy, D., Vasan, R.S. 2003. Plasma homocysteine, hypertension incidence and blood pressure tracking: the Framingham Heart Study. Hypertension. 42:1100-110.

Interpretive Summary: Several epidemiological studies have demonstrated that elevated plasma total homocysteine has a modest effect on risk of cardiovascular disease. The vascular risk associated with hyperhomocysteinemia has been observed to be stronger in hypertensive individuals. More recently, attention has been focused on the direct relations of plasma homocysteine to blood pressure and hypertension because of the suggestion that the adverse risk associated with hyperhomocysteinemia may be mediated in part by the positive association of homocysteine with hypertension. However, it is possible that the previous cross sectional relation of plasma homocysteine to blood pressure may be due to hyper¬homocysteinemia being a marker for nephrosclerosis and mild renal 2 dysfunction. No prior study has examined prospectively the relation of plasma homocysteine to hypertension incidence. Therefore, we investigated the prospective relations of baseline plasma total homocysteine levels to hypertension incidence and blood pressure tracking in 2104 Framingham Heart Study participants (mean age 57 years, 58% women), who were free of hypertension, heart disease, or renal failure at baseline. On follow up four years, we observed no significant relations between plasma homocysteine and incidence of hypertension or blood pressure progression. In conclusion, we found no evidence that homocysteine levels were related to hypertension incidence or longitudinal blood pressure progression in a large community based sample of non hypertensive individuals. Additional prospective investigations are warranted to confirm our observations.

Technical Abstract: Although plasma homocysteine is cross sectionally associated with blood pressure in large community based studies, it is not known if elevated plasma homocysteine predicts hypertension incidence. We investigated the relations of baseline plasma total homocysteine levels to Hypertension incidence and blood pressure tracking in 2104 Framingham Heart Study participants (mean age 57 years, 58% women), free of hypertension, myocardial infarction, heart failure, atrial fibrillation, or renal failure at baseline. on follow up four years from baseline, 360 Persons (17.1%) developed hypertension and 878 persons (41.7%) had progressed to a higher blood pressure stage. In unadjusted analyses, each one standard deviation increment in the logarithm of homocysteine values there was associated with an increased odds of developing hypertension, odds ratio (OR) 1.18 (95-08 confidence interval 1.05-1.32) and an increased odds of blood pressure progression, OR 1.17 (1.07-1.27). The relations of plasma homocysteine to the incidence of hypertension or blood pressure progression were statistically non significant in age and sex adjusted logistic regression models and in multivariable models adjusted for age, sex, body mass index, diabetes, interim weight change, smoking, creatinine, and baseline blood pressure and blood pressure category. In conclusion, we found no major relation of baseline plasma homocysteine levels to hypertension incidence or longitudinal blood pressure progression in a large community based sample of non hypertensive individuals after adjustment for age, sex and other important covariates. Additional prospective investigations are warranted to confirm our observations.