The impact of serum homocysteine on intima-media thickness in normotensive, white-coat and sustained hypertensive adolescents

Abstract

Background and purpose. In recent decades, elevated levels of homocysteine (Hcy) have been found to be associated with an increased risk of vascular events. Additionally, in some casecontrol studies, hyperhomocysteinaemia has been found to be related to higher intima-media thickness (IMT), but the results are inconclusive. Therefore, in the present study we intended to assess the relationship between serum levels of Hcy and IMT in normotensive and hypertensive adolescents. Patients and methods. 59 normotensive 47 white coat hypertensive and 73 sustained hypertensive adolescents were included in our study. IMT of the common carotid arteries was measured by B-mode ultrasonography. Plasma NOx as well as homocysteine levels were measured in all cases. The relationship between IMT and Hcy and NOx were assessed by a pooled analysis. Additionally, serum levels of Hcy and NOx were compared between normotensives and hypertensive subgroups. Results. IMT was elevated in hypertensive adolescents (means ± SD: 0.055 ± 0.01 cm) compared with normotensives (0.048 ± 0.008 cm, p < 0.01). Higher serum concentrations of homocysteine were measured in hypertensive teenagers (11.9 ± 7.25 mol/l for hypertensive and 9.85 ± 3.12 mol/l for normotensives respectively, p < 0.01). In contrast to this, serum NOx was lower in patients (28.8 ± 14.9 mol/l) compared with controls (38.8 ± 7.6 mol/l, p < 0.01). The pooling of homocysteine and IMT data of hypertensive and normotensive adolescents revealed a significant positive relationship between the two parameters (r = 0.43, p < 0.001). Conclusions. We conclude that elevated serum levels of homocysteine may play a role in increased IMT in adolescent hypertension. © 2012 Scandinavian Foundation for Cardiovascular Research.