Journal Article

Homocysteine and Blood Pressure in the Third National Health and Nutrition Examination Survey, 1988–1994

Unhee Lim and Patricia A. Cassano

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 156, issue 12, pages 1105-1113
Published in print December 2002 | ISSN: 0002-9262
Published online December 2002 | e-ISSN: 1476-6256 | DOI:
Homocysteine and Blood Pressure in the Third National Health and Nutrition Examination Survey, 1988–1994

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Studies suggest that homocysteine may elevate blood pressure and increase the risk of hypertension. The association of homocysteine with blood pressure and with the risk of hypertension was investigated using cross-sectional data from the Third National Health and Nutrition Examination Survey (1998–1994). Homocysteine had an independent positive association with blood pressure after adjusting for cardiovascular risk factors. A 1 standard deviation (∼5 µmol/liter) increase in homocysteine was associated with increases in diastolic and systolic blood pressure of 0.5 and 0.7 mmHg, respectively, in men and of 0.7 and 1.2 mmHg in women. Similarly, higher levels of homocysteine were associated with an increased risk of hypertension. In a comparison of the highest and lowest quintiles of homocysteine, women had a threefold increase in the risk of hypertension (95% confidence interval (CI): 1.7, 5.4), and men had a twofold increase (95% CI: 0.7, 5.1). In light of the homocysteine-blood pressure association, the association of homocysteine with prevalent cardiovascular disease was examined with and without adjusting for blood pressure. The results support a mediating role for blood pressure in women and suggest that the full effect of homocysteine on cardiovascular risk may be underestimated when blood pressure is adjusted.

Keywords: biological markers; blood pressure; cardiovascular diseases; folic acid; homocysteine; hypertension; pyridoxine; Abbreviations: CI, confidence interval; DASH, Dietary Approaches to Stop Hypertension; NHANES III, Third National Health and Nutrition Examination Survey.

Journal Article.  6738 words. 

Subjects: Public Health and Epidemiology

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