Plasma homocysteine, aortic stiffness, and renal function in hypertensive patients
Plasma homocysteine, aortic stiffness, and renal function in hypertensive patients
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DOI：
10.1161/01.hyp.34.4.837
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发表时间：
1999-10-01
期刊：
影响因子：
8.3
通讯作者：
Blacher, J
中科院分区：
文献类型：
--
作者：
Bortolotto, LA;Safar, ME;Blacher, J
高同型半胱氨酸血症与血管结构改变和血管临床终点有关。为了评估血浆同型半胱氨酸、大动脉的结构和功能以及临床血管疾病的存在之间的关系，我们调查了236名高血压患者。我们通过测量颈动脉-股动脉的脉搏波速度来评估动脉硬度。用荧光高效液相色谱法测定血浆总同型半胱氨酸。心血管疾病的存在是根据临床事件定义的，包括冠心病、脑血管疾病和外周血管疾病。在该人群中，脉搏波速度与同型半胱氨酸呈正相关，即使在调整了年龄、平均血压、动脉粥样硬化程度和肌酐清除量后也是如此(P=0.016)。方差分析显示，根据动脉粥样硬化的程度，同型半胱氨酸、肌酐清除率和脉搏波速度的平均值之间存在统计学差异，这3个参数的增加伴随着参与动脉粥样硬化的血管部位的增加。总而言之，在高血压患者中，同型半胱氨酸水平与以主动脉脉搏波速度测量的动脉僵硬有强烈且独立的相关性。在有临床血管疾病的患者中，血浆同型半胱氨酸、肌酐清除率和主动脉脉搏波速度较高。这些结果表明，评估主动脉扩张性和同型半胱氨酸水平有助于高血压人群的心血管风险评估。
Hyperhomocysteinemia has been associated with both vascular structure alterations and vascular clinical end points. To assess the relation between plasma homocysteine, structure and function of large arteries, and the presence of clinical vascular disease, we investigated a population of 236 hypertensive patients. We estimated arterial stiffness by measuring the carotid-femoral pulse wave velocity. Total plasma homocysteine was determined by fluorometric high-performance liquid chromatography. The presence of cardiovascular disease was defined on the basis of clinical events, including coronary heart disease, cerebrovascular disease, and peripheral vascular disease. In this population, pulse wave velocity was positively correlated with homocysteine, even after adjustments for age, mean blood pressure, extent of atherosclerosis, and creatinine clearance (P=0.016). Analysis of variance showed statistically significant differences between the mean values of homocysteine, creatinine clearance, and pulse wave velocity according to the extent of atherosclerosis, with an increase in these 3 parameters concomitant with an increase in the number of vascular sites involved with atherosclerosis. In conclusion, in hypertensive patients the levels of homocysteine are strongly and independently correlated to arterial stiffness measured by aortic pulse wave velocity. Plasma homocysteine, creatinine clearance, and aortic pulse wave velocity are higher in patients presenting with clinical vascular disease. These results suggest that the evaluation of aortic distensibility and homocysteine levels can help in cardiovascular risk assessment in hypertensive populations.