Blood amino acid linked to higher heart and stroke risk
The highest-level group had higher relative risk than the lowest: adjusted hazard ratios of 1.53 with intensive blood pressure control and 1.33 with standard control.
Randomized trial, multicenter
Limit: Homocysteine groups were compared in a post hoc analysis
Edited by Boris Djordjevic · AgingResearch.News
In 11,220 people with high blood pressure and high cardiovascular risk, averaging 64.6 years old, researchers analyzed homocysteine, an amino acid found in blood. This post hoc analysis used data from the ESPRIT randomized trial. The trial assigned participants to systolic blood pressure targets below 120 or below 140 millimeters of mercury. Systolic pressure is the top number in a blood pressure reading.
Researchers grouped participants by their starting homocysteine levels. The highest-level group had greater risk than the lowest of a combined outcome: heart attack, procedures to restore blood flow, hospitalization for heart failure, stroke or cardiovascular death. Homocysteine levels did not modify the effect of intensive blood pressure control. Differences in its effects on kidney and safety outcomes across groups were not statistically significant. The abstract gave no numerical safety results.
Why it matters
For cardiovascular health in later life, a key question is whether blood markers can help identify who benefits from tighter blood pressure control.
Caveats
Homocysteine levels were not randomized, so their association with cardiovascular events does not establish causation. Within each homocysteine group, the range of likely effects of intensive versus standard control included no difference.
