<p>Joint Effects of Plasma Homocysteine Concentration and Traditional Cardiovascular Risk Factors on the Risk of New-Onset Peripheral Arterial Disease</p>

Abstract

Purpose: Hyperhomocysteinemia is an independent risk factor for cardio-and cerebrovascular diseases. However, the relationship between plasma homocysteine (Hcy) concentration and peripheral arterial disease (PAD) has not been completely characterized. The aim of the present study was to determine the relationship between plasma Hcy concentration and new-onset PAD and to assess the effects of combinations of Hcy and traditional cardiovascular risk factors. Patients and Methods: We conducted a prospective community-based cohort study of 3119 Chinese participants who did not have PAD at baseline, with a median follow-up period of 2.30 years. We used multivariate logistic regression models to evaluate the relationship between high Hcy (≥10µmol/L) and new-onset PAD. The effects of combinations of high Hcy and traditional cardiovascular risk factors were assessed using logistic regression analysis. Results: After adjustment for 14 covariates, high Hcy concentration was significantly associated with new-onset PAD (odds ratio [OR]=2.08, 95% confidence interval [CI]: 1.-08-4.03, P=0.030). Smokers with high Hcy concentration were substantially more likely to have new-onset PAD than non-smokers with normal Hcy concentration (OR=4.44, 95% CI: 1.77-11.12, P=0.001). The effect of diabetes on PAD became significant when present in combination with high Hcy concentration (OR=3.67, 95%

Effects of individualized administration of folic acid on prothrombotic state and vascular endothelial function with H-type hypertension

“…[ 8 ] H-type hypertension influences BP and cardiovascular health outcomes. [ 20 , 21 ] Other studies have highlighted that MTHFR C677T genotyping is important. [ 22 , 23 ] In a recent study of hypertension, hypertension in a small population of people was found to be related to a prothrombotic state, [ 24 ] which suggests that the prothrombotic state is a negative influencing factor in hypertension.…”

Association of Plasma Bilirubin Levels With Peripheral Arterial Disease in Chinese Hypertensive Patients: New Insight on Sex Differences

“…The mean serum Hcy was 20.50 (13.64) μmol/L and 15.77 (7.35) μmol/L among males and females, respectively. Recent studies have shown that hyperhomocysteinemia is associated with an increased risk of PAD ( Liu et al, 2020 ). Hyperhomocysteinemia can directly or indirectly produce toxic effects on vascular endothelial cells by damaging vascular endothelial cells, promoting platelet activation, enhancing coagulation, producing cytotoxic reactive oxygen species, reducing antioxidation and proliferation of vascular smooth muscle cells, thus promoting atherosclerosis ( Liu et al, 2020 ).…”

“…Recent studies have shown that hyperhomocysteinemia is associated with an increased risk of PAD ( Liu et al, 2020 ). Hyperhomocysteinemia can directly or indirectly produce toxic effects on vascular endothelial cells by damaging vascular endothelial cells, promoting platelet activation, enhancing coagulation, producing cytotoxic reactive oxygen species, reducing antioxidation and proliferation of vascular smooth muscle cells, thus promoting atherosclerosis ( Liu et al, 2020 ). According to previous studies, bilirubin is an antioxidant that can prevent atherosclerosis, but there is no study on the pathological mechanism between bilirubin and homocysteine.…”

Long-term Prognostic Value of Homocysteine in Patients with Acute Coronary Syndrome Complicated with Hypertension: A Multicenter Retrospective Study

“…Therefore, using de nite cut-off values of Hcy concentration de ned by guidelines or previous classical studies for risk strati cation may underestimate the actual risk of patients. In addition, because homocysteine and hypertension have a synergistic effect on the prognosis of cardiovascular disease [9], homocysteine may have different effects on prognosis of ACS patients with complicated hypertension or not. As a result, we divided ACS patients into hypertension and non-hypertension groups and used ROC analysis to determine the optimal critical value of homocysteine for predicting long-term death in ACS patients in each of the two groups.…”

“…In addition, the increase in Hcy level is strongly associated with the occurrence and development of hypertension by inhibiting endogenous hydrogen sul de generation and activating angiotensin-converting enzymes [7,8]. Meanwhile, [9,10] reported that hypertension and hyperhomocysteinemia have a signi cant synergistic effect on cardiovascular disease prognosis. Therefore, Hcy may have a different in uence on prognosis in hypertensive and non-hypertensive patients.…”