Abstract
The study sought to determine whether there is any relationship between plasma homocysteine and blood pressure levels in Nigerians with essential hypertension. It was a cross-sectional analytical study done on 120 randomly selected hypertensive patients and 120 normal healthy controls seen at the large Conference hall of the Ahmadu Bello University (ABU) Medical Centre, Zaria as well as the ABU Teaching Hospital, Zaria, Northern-Nigeria. Pearson's Correlation and Binary Logistic Regression analysis determined the relationship between homocysteine and hypertension. Hyperhomocysteinaemia found in the hypertensive patients (22.8 ± 6.6 µmol/L) differed significantly (p<0.001) from controls (10.9 ± 2.8 µmol/L) with significant (p<0.001), blood pressure difference between both groups. Homocysteine significantly positively correlated with systolic (r = 0.51, p<0.001) and diastolic (r = 0.47, p<0.001) blood pressures in hypertensive subjects. The relation of plasma hcy to hypertension was statistically significant for SBP; OR: 1.08 (95% CI, 1.05-1.11) and DBP; OR: 1.08 (95% CI, 1.03-1.13) in the unadjusted model. When adjusted for confounding variables, hcy was significantly related to SBP; OR: 1.1 (95% CI, 1.04-1.18) but not DBP (p=0.25; OR: 1.06 (95 % CI, 0.96-1.18). The mean plasma folate level was high (115.2 ± 48.0 ng/mL) in the hypertensive subjects. The hyperhomocysteinaemic subjects showed a 2.8 times Odds of developing hypertension. This study showed higher mean plasma homocysteine levels in hypertensives than controls not accounted for by sub-optimal folate levels. Hyperhomocysteinaemia showed a positive relationship to systolic hypertension after adjusting for confounders.
Highlights
Hypertension is a major risk factor for arteriosclerosis which results in cardiovascular diseases such as stroke and myocardial infarction[1,2]
Group Profile There were a total of 120 hypertensive subjects consisting of 83 (69.2%) females and 37 (30.8%) males and 120 normal healthy controls consisting of 65 (54.2%) females and 55 (45.8%) males
Following adjustment for age, sex, weight, body mass index (BMI), glomerular filtration rate (GFR), creatinine, urea, duration of hypertension, vegetables and fruits in daily diet, plasma folate, level of education, fasting blood glucose and packed cell volume (PCV), homocysteine showed a significant (p=0.002, Odds Ratio (OR): 1.1 positive relationship to systolic blood pressure but not diastolic (p=0.25, OR: 1.06 blood pressure (Table 5)
Summary
Hypertension is a major risk factor for arteriosclerosis which results in cardiovascular diseases such as stroke and myocardial infarction[1,2]. It was responsible for a third of all deaths worldwide[3] and it is projected that by the year 2025, 1.56 billion adults will be living with hypertension worldwide[4]. Hypertension was rare in Africans in the beginning of the twentieth century. African Health Sciences Vol 20 Issue 1, March, 2020 cise, adoption of "Western" lifestyle and intake of diets rich in salt, refined sugar, unhealthy fats and oils and of low fibre content[5]. The 7th report of the Joint National Committee on the Detection, Evaluation and Treatment of Hypertension advocates that hypertension is a controllable and preventable disease as modification of lifestyle such as smoking and alcohol cessation, exercise and dietary approaches to stop hypertension (DASH diet) have been shown as effective methods in its prevention and treatment[9]
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