Hyperhomocysteinemia: a variability factor of the daily blood pressure profile in patients with arterial hypertension and excess body weight

Abstract

Introduction. Arterial hypertension in patients with excess body weight is associated with a rapid progression of cardiovascular events.

The aim. To determine the effect of homocysteine on the daily profile of blood pressure and blood glucose and its dependence on the level of anxiety.

Materials and methods. 103 patients (52 women and 51 men) with arterial hypertension and excess body weight were examined. A laboratory blood test, Holter monitoring of blood pressure were conducted, levels of personal and reactive anxiety were determined.

Results. The average level of homocysteine in patients was 14.3±6.0 μmol/l, and was 1.6 times higher than in healthy individuals. Hyperhomocysteinemia was found in 37% of patients. On average, they had a higher level of glycemia (6.2±0.9 mmol/l vs 5.7±0.8 mmol/l), average daily systolic blood pressure (128.0±10.7 mmHg vs 121.5±10.1 mmHg) and variability of both systolic (respectively, 18.9±4.4 vs 15.1±2.5) and diastolic blood pressure (16.8±3.5 vs 12.8±1.8); personal (respectively, 43.3±6.3 points vs 38±6.4 points;) and reactive anxiety (38.2±4.6 points vs 34.1±5.2). A mathematical model for forecasting hyperhomocysteinemia in overweight patients has been developed, which allows to identify a group of patients (about 62%) with a high risk of developing complications.

Conclusion. Hyperhomocysteinemia was found in 37% of patients with arterial hypertension and excess body weight. These patients were distinguished by higher anxiety, higher blood glucose levels, high variability of the daily blood pressure profile, which increases the risk of cardiovascular events..