关键词: 同型半胱氨酸, 原发性高血压, 危险因素

Abstract:

Objective　 To study the levels of plasma homocysteine(Hcy) in patients with primary hypertension,and to investigate the relationship of Hcy with cardiovascular risk factors and subclinical damage. Methods　 According to the echocardiogram, carotid artery ultrasonic inspection and isotope glomerular filtration rate (iGFR) Chinese Guidelines for the Management of Hypertension, the target damage was analyzed and evaluated (if patients had 2 or more than 2 target damages, they were classified into the groups below and analyzed statistically), and 106 primary hypertension patients were classified into the simple hypertension group (44 patients), the hypertension with left ventricular hypertrophy group (18 patients), the hypertension with carotid atherosclerosis group (46 patients) and the hypertension with decreasing iGFR group (27 patients). Plasma Hcy,fasting plasma glucose (FPG), lipid and creatinine (Cr) were measured, and the results were compared and analyzed by Spearman correlation analysis and multi-logistic regression analysis. Results　 Hcy was positively correlated with subclinical damage and some traditional cardiovascular risk factors [sex, age, smoking, systolic blood pressure (SBP), FPG and Cr](P<0.05).The Hcy levels of the simple hypertension group [(12.18±3.30) μmol/L] were lower than those of the hypertension with decreasing iGFR group[(19.05±8.58) μmol/L], the hypertension with left ventricular hypertrophy group [(18.63±7.99) μmol/L] and the hypertension with carotid atherosclerosis group [(16.80±6.34) μmol/L] (P<0.05). Age,Hcy,FPG and iGFR had statistical significance between the simple hypertension group and the hypertension with carotid atherosclerosis group(P<0.05). Non-carotid atherosclerosis was as dependent variable, and age, FPG, iGFR and Hcy were as independent variables. Multi-logistic regression analysis showed that age was independently associated with carotid atherosclerosis. If only defined Hcy as normal and increasing with the abnormal cut-off value of Hcy >15 μmol/L according to the American Heart Association,the risk of carotid atherosclerosis in hypertension patients with increasing Hcy was 2.74 times higher than than in subjects with normal Hcy. Conclusions　 Age is an important independent risk factor for carotid atherosclerosis in primary hypertension patients. The increasing of Hcy is closely related with subclinical damage,and has a high risk for carotid atherosclerosis.

Key words: Homocysteine, Primary hypertension, Risk factor