Prevalence of hyperhomocysteinemia and its associated factors in patients with primary hypertension in Chinese urban communities: A cross-sectional study from Nanjing.

ABSTRACT

OBJECTIVE: This study aimed to investigate the prevalence of hyperhomocysteinemia (Hhcy) and its major determinants in Chinese urban population with new-onset hypertension. METHODS: A total of 574 adults (404 men and 170 women) with newly diagnosed primary hypertension were recruited from seven communities in Nanjing, China. Data on lifestyle factors, such as physical activities, current smoking and drinking status, dietary habits, and familial factors were collected in interviews, and laboratory examinations were performed by well-trained personnel. Potential factors related to the prevalence of Hhcy in this population were analyzed using a logistic regression model. RESULTS: Of the 574 participants, 421 (73.3%) were diagnosed with Hhcy whereas the remainder were only hypertensive. The study highlighted a number of factors that were significantly correlated (p < 0.001) with the prevalence of Hhcy. Subjects with Hhcy were more likely to be male (odds ratio [OR] 3.007, 95% confidence interval [CI] 1.781-5.079), have a smoking history (OR 1.052, 95% CI 1.031-1.074), older (OR 1.052, 95% CI 1.031-1.074), have an elevated Body Mass Index BMI (OR 1.160, 95% CI 1.080-1.246) and higher levels of low density lipoprotein cholesterol (LDL-c) (OR 1.590, 95% CI 1.226-2.063). Regular and adequate physical activity was associated with normal homocysteine levels in both male and female groups (p < 0.05). For males only, having a higher BMI, higher LDL-c or being older significantly (p < 0.05) affected the chances of Hhcy. Whereas for females, lower levels of eGFR could be related to Hhcy (p < 0.05). CONCLUSIONS: Our present study reported a high prevalence of Hhcy in the Nanjing population with new-onset hypertension. Associated factors like physical activity, gender, smoking history, age, BMI, and LDL-c were important modifiers of plasma homocysteine concentration. Management and intervention of the above associated factors should be implicated to improve H type hypertension control.