Hypertension-Mediated Organ Damage Correlates With Serum Homocysteine Level in Community-Dwelling Elderly Chinese: The North Shanghai Study

Introduction: Serum homocysteine (Hcy) level is associated with cardiocerebrovascular disease. However, the relationship between Hcy and hypertension-mediated organ damage (HMOD) in non-hospitalized residents has not been elucidated. We aimed to investigate the association of HMOD with Hcy in elderly Chinese. Methods: 1744 community-dwelling elderly Chinese (age ≥65 years) participated in the Northern Shanghai Study from Jun. 2014 to Aug. 2015. Hyperhomocysteinemia (HHcy) was defined as serum Hcy ≥15mmol/L, and HMOD was estimated as arterial stiffness (carotid-femoral pulse wave velocity (CF-PWV) and ankle-brachial index (ABI)), cardiac impairment (left ventricular (LV) hypertrophy and LV diastolic dysfunction), and renal dysfunction (estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio). Linear and logistic regression models were built to explore the associations of HMOD with Hcy. Results: Among 1744 participants, 632 (36.2%) were diagnosed as HHcy. HHcy group had more men (61.2% vs 35.3%), with higher age (73.7±6.7 vs 70.4±5.3 years) and BMI (24.2±3.4 vs 23.7±3.5 kg/m2). Linear regression analysis showed that serum Hcy level was positively associated CF-PWV and negatively associated with ABI and eGFR. By logistic regression, HHcy was significantly associated with abnormal CF-PWV (odds ratio (OR)=1.53, 95% confidence interval (CI) 1.08 to 2.16) and ABI (OR=1.55, 95% CI 1.17 to 2.04), and decreased eGFR (OR=7.09, 95% CI 4.03 to 12.47) after adjustment for covariates. Moreover, similar associations of serum Hcy level with CF-PWV and eGFR were observed in subgroups by gender and hypertensive state. Conclusion: HMOD, particularly renal dysfunction and arterial stiffening, was significantly and independently associated with increased serum Hcy level in the elderly Chinese.