Combination of hyperhomocysteinemia and hypertension in patients with atherosclerosis of brachiocephalic arteries: the frequency, clinical and laboratory correlates

Combination of hypertension (HTN) and hyperhomocysteinemia > 10 mсmol/l is frequently called H-type hypertension. It is associated with an increased risk of vascular events including stroke.

Objective. To estimate the frequency and clinical and laboratory correlates of combination of hyperhomocysteinemia and HTN in a cohort of patients with atherosclerosis of brachiocephalic arteries (BCA).

Design and methods. We recruited out-patients with confirmed atherosclerosis of BCA based on the ultrasound duplex scans. History were registered. Complete blood count, biochemical analysis (lipids, creatinine, homocysteine and C-reactive protein) and urine analysis were performed.

Results. Data from 93 patients were analyzed. The frequency of combination of hyperhomocysteinemia and HTN among patients with atherosclerosis of BCA was 95%. The level of homocysteine was higher in males than in females (p = 0,001). Correlation analysis showed a direct weak association between the level of homocysteinemia and the number of white blood cells, red blood cells, monocytes, level of creatinine in the blood and microalbuminuria (p < 0,05). Linear regression analysis showed that male gender along with microalbuminuria were independent predictors of the homocysteine level in these patients.

Conclusions. A combination of hyperhomocysteinemia and HTN is common among patients with the atherosclerosis of BCA. Stroke prevention measures in patients with HTN and atherosclerosis of BCA should include assessment of homocysteine level and prescription of B vitamins if needed.

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