High Homocysteine Levels Are Independently Related to Isolated Systolic Hypertension in Older Adults

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Abstract
Background The association between homocysteine and isolated systolic hypertension in older adults was evaluated using a case-control design, and the relationship between homocysteine and clinical or subclinical atherosclerosis was explored. Methods and Results Cases were 179 adults ≥60 years with a systolic blood pressure of ≥160 mm Hg and diastolic blood pressure P <.001). After control for potential confounders, homocysteine remained significantly associated with systolic hypertension ( P =.019). For the hypertensive group, there was no apparent association between level of homocysteine and prevalence of atherosclerosis. However, among the normotensive group, the prevalence of atherosclerosis went from 22% in the lowest quintile of homocysteine values to 53% in the fifth quintile, with an odds ratio of 4.1 (fifth quintile in comparison to the first, P <.05). After adjustment for age, sex, systolic blood pressure, cholesterol, and smoking, this odds ratio increased to 6.4 ( P <.01). Conclusions Elevated levels of homocysteine may be related to the cause of isolated systolic hypertension in some individuals. In normotensive older adults, homocysteine appears to be an independent risk factor for atherosclerosis.

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