Elevated Homocysteine Levels Are Associated With the Metabolic Syndrome and Cardiovascular Events in Hypertensive Patients

Catena, Cristiana; Colussi, GianLuca; Nait, Francesca; Capobianco, Frine; Sechi, Leonardo A.

doi:10.1093/ajh/hpu248

Cited by 81 publications

(57 citation statements)

References 39 publications

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“…Although the underlying mechanisms by which lower folate status contributes to mortality remain unclear, some possible explanations could be considered. One hypothesis is that inadequate folate would disturb the DNA methylation process [18], and others state that folate deficiency can induce a raised homocysteine level [19], which is recognized as a risk factor of CVD occurrence [20,21] as well as mortality [22]. It must be noted that the higher mortality rates are not restricted to persons with folate deficiency (serum folate concentrations b 10 nmol/L) [23], but even extended to those with normal concentrations.…”

Section: Discussionmentioning

confidence: 99%

Serum folate concentrations and all-cause, cardiovascular disease and cancer mortality: A cohort study based on 1999–2010 National Health and Nutrition Examination Survey (NHANES)

Yang

Dong

Wang

2016

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Serum folate concentrations and all-cause, cardiovascular disease and cancer mortality: A cohort study based on 1999–2010 National Health and Nutrition Examination Survey (NHANES)

Yang

Dong

Wang

2016

International Journal of Cardiology

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“…Elevated factor VIII and hyperhomocysteinemia were not considered as part of thrombophilia in the current analysis because these correlate with traditional cardiovascular risk factors and each other. 13,16,17 Missing values of other variables were allowed, and if the variable served as an adjustment covariate in a model, its missing values were substituted by its mean in the overall sample to retain maximum numbers of events. Given the low prevalence of missing values in the data set, this simple adjustment for missing values should not influence the estimates, and its effect was evaluated in a complete-case analysis.…”

Section: Discussionmentioning

confidence: 99%

Interaction of Hereditary Thrombophilia and Traditional Cardiovascular Risk Factors on the Risk of Arterial Thromboembolism

Mahmoodi

Veeger

Lijfering

et al. 2016

Circ Cardiovasc Genet

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Endothelial damage and subsequent atherosclerosis are considered the main etiologic factors for ATE, whereas coagulation disturbance and stasis of the blood are major risk factors for VTE. 6 This is also consistent with the much higher relative risk of VTE as compared with ATE in individuals with hereditary thrombophilia. [2][3][4][5] Although the process of atherosclerosis is driven by traditional cardiovascular risk factors, such as hypertension, diabetes mellitus, smoking, hyperlipidemia, and obesity, the occurrence of ATE (ie, transient ischemic attack, ischemic stroke, or myocardial infarction) is typically caused by rupture of atherosclerotic plugs with subsequent thrombus formation.6 Therefore, synergistic interaction of hereditary Background-Hereditary thrombophilia is associated with a slightly increased risk of arterial thromboembolism (ATE).Whether hereditary thrombophilia interacts with traditional cardiovascular risk factors on the risk of ATE has yet to be established. Methods and Results-A total of 1891 individuals belonging to 4 family cohorts from the Netherlands were included in the analyses. Five hereditary thrombophilic defects, including factor V Leiden, prothrombin G20210A defect, and deficiencies of the natural anticoagulants (ie, antithrombin, protein C, and protein S), were assessed, and data on risk factors and previous ATE were collected. Thrombophilia was associated with elevated risk of ATE (hazard ratio =1.74, 95% confidence interval, 1.18-2.58; P=0.005). Overall, the association of thrombophilia with ATE tended to be stronger in the presence of traditional cardiovascular risk factors, especially the synergistic effect of thrombophilia with diabetes mellitus was striking (hazard ratio of thrombophilia-ATE association was 1.41 in nondiabetics versus 8.11 in diabetics). Moreover, the association of thrombophilia with ATE tended to be stronger in females and before the age of 55 years as compared with males and individuals >55 years of age, respectively. Conclusions-Thrombophilia is associated with ATE. This association may be stronger in the presence of traditional cardiovascular risk factors in particular in individuals with diabetes mellitus. Future studies on thrombophilia-ATE risk should focus on high-risk populations with high prevalence of traditional cardiovascular risk factors. (Circ Cardiovasc Genet. 2016;9:79-85.

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“…This amino acid appears to be relevant in the pathogenesis of atherogenesis by inducing prothrombotic and proinflammatory effects, increased oxidative stress, endothelial dysfunction, and smooth muscle cell proliferation [30]. Elevated plasma homocystein levels are associated with increased cerebro-cardiovascular events in MeS [31]. In obese patients, homocysteine concentrations are elevated and correlate well with serum levels of leptin [32].…”

Section: Cardiovascular Systemmentioning

confidence: 99%

Clinical Scenario of the Metabolic Syndrome

et al. 2016

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The term metabolic syndrome (MeS) refers to a cluster of associated symptoms composed of impaired fasting glucose, abdominal obesity, hypertension, and dyslipidemia. MeS is associated with an increased risk of cardiovascular and diabetes-associated morbidity and mortality. The increased amount of visceral fat together with a chronic inflammatory state predisposes to the development of arteriosclerosis. Furthermore, insulin resistance (IR) and dyslipidemia are associated with fatty liver disease. In addition, MeS is linked to non-cardiovascular diseases such as cancer as well as psychiatric or endocrine disorders. Here, we discuss the clinical impact of MeS in cardiovascular and non-cardiovascular diseases to highlight the importance of prevention, early diagnosis, and multifactorial treatment of high-risk individuals.

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Elevated Homocysteine Levels Are Associated With the Metabolic Syndrome and Cardiovascular Events in Hypertensive Patients

Abstract: Elevated plasma Hcy is associated with the metabolic syndrome in hypertensive patients. Prevalence of events increases with increasing plasma Hcy levels suggesting a contribution of Hcy to cerebro-cardiovascular diseases in these patients.

Cited by 81 publications

References 39 publications

Serum folate concentrations and all-cause, cardiovascular disease and cancer mortality: A cohort study based on 1999–2010 National Health and Nutrition Examination Survey (NHANES)

Serum folate concentrations and all-cause, cardiovascular disease and cancer mortality: A cohort study based on 1999–2010 National Health and Nutrition Examination Survey (NHANES)

Interaction of Hereditary Thrombophilia and Traditional Cardiovascular Risk Factors on the Risk of Arterial Thromboembolism

Clinical Scenario of the Metabolic Syndrome

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