The prevalence, relative risk factors and MTHFR C677T genotype of H type hypertension of the elderly hypertensives in Shanghai, China: a cross-section study

Xiao-Lin Qian,Zhi-Feng Yao,Hong Cao,Xu-Cheng Lv,Min-Na Tang,Jun-Bo Ge,Jun Zhang,Lei Zhang,Lei Shen,Bin Hong,Zhi-Hui Gu,Xue-Juan Jin,Jun Zhou,Zhao-Qiang Cui,Wei-Qin Tang,Jia-Lu Hu

doi:10.1186/s12872-021-02151-x

Abstract

BackgroundH type hypertension is defined as homocysteine (Hcy) ≥ 10 μmol/L in combination with primary hypertension. Studies demonstrated that the existence of hyperhomocysteine (HHcy) in hypertensive exacerbates the poor outcome of cardiocerebral incidents. This study was to investigate the current epidemic situation of H type hypertension and determine the risk factors in order to find intervention targets for H type hypertensives.MethodsWe conducted a cross-sectional study using cluster sampling design in Shanghai, China from July 2019 and April 2020. 23,652 patients with primary hypertension were enrolled in this study. Their medical information was recorded, and the level of Hcy concentrations and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms were detected.ResultsIn total, 22,731 of 23,652 patients were recorded. The mean age was 68.9 ± 8.6 y and 43% were men. 80.0% of the enrolled patients had H type hypertension. The frequency of allele T was 40.9%, and the proportions of the CC, CT, and TT genotypes were 36.1%, 46.0%, and 17.9%, respectively. Compared with the TT genotype, the plasma Hcy concentration levels were lower in patients with the CC/CT genotype (18.96 ± 13.48 μmol/L vs. 13.62 ± 5.20/14.28 ± 5.36, F = 75.04, p < 0.01). The risk for H type hypertension was higher in elderly people. Men had ~ 5.55-fold odds of H type hypertension compared with women. Patients with CT genotype and TT genotype had ~ 1.36- and ~ 2.76-fold odds of H type hypertension compared with those with CC genotype, respectively. Smoking and diabetes were not significantly associated with H type hypertension.ConclusionsThe prevalence of H type hypertension in patients with primary hypertension was 80.0%, which was higher than the 75% found in prior report in China. Age, gender, and MTHFR C677T polymorphisms rather than smoking and diabetes were independently associated with H type hypertension.

Highlights

H type hypertension is defined as homocysteine (Hcy) ≥ 10 μmol/L in combination with primary hypertension
The prevalence of H type hypertension in patients with primary hypertension was 80.0%, which was higher than the 75% found in prior report in China
Gender, and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms rather than smok‐ ing and diabetes were independently associated with H type hypertension

Summary

Introduction

H type hypertension is defined as homocysteine (Hcy) ≥ 10 μmol/L in combination with primary hypertension. Liu et al found that Hcy was an independent predictor of major adverse cardiac events in patients with acute coronary syndrome (ACS). Hcy was found to be significantly associated with the Global Registry of Acute Coronary Events (GRACE) risk score suggested by the research of 361 patients with ACS and a median follow-up of 43.3 months [9]. In a study consisting of 1823 stroke patients, after a follow-up of a median of 4.5 years, patients with high Hcy concentrations were associated with an increased risk of 1.74-fold for stroke recurrence, and 1.75-fold for all-cause mortality when compared to a low concentration group [4]

Objectives

Methods

Results

Conclusion