Homocysteine and hypertension in persons with spinal cord injury

• Published in: Spinal cord Vol. 44; no. 8; pp. 474 - 479
• Main Authors: LEE, M. Y, MYERS, J, ABELLA, J, FROELICHER, V. F, PERKASH, I, KIRATLI, B. J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing 01.08.2006; Nature Publishing Group
• Subjects: Age Distribution; Biological and medical sciences; California - epidemiology; Cerebrospinal fluid. Meninges. Spinal cord; Cerebrospinal fluid. Spinal cord. Spinal roots. Spinal nerves; Female; Homocysteine - blood; Humans; Hypertension - blood; Hypertension - epidemiology; Incidence; Injuries of the nervous system and the skull. Diseases due to physical agents; Kidney Diseases - blood; Kidney Diseases - epidemiology; Male; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Neurosurgery; Risk Assessment - methods; Risk Factors; Spinal Cord Injuries - blood; Spinal Cord Injuries - epidemiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Traumas. Diseases due to physical agents; Veterans - statistics & numerical data; California; Hypertension; homocysteine; spinal cord injury; Nervous system diseases; Vertebral canal; Homocystein; Spinal cord trauma; Central nervous system disease; Cardiovascular disease; renal function; Spinal cord disease
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sj.sc.3101873

Cross-sectional analysis of a convenience sample of locally recruited participants, including both patients and volunteers. To determine whether there is an association between plasma homocysteine and hypertension in persons with spinal cord injury (SCI). Spinal Cord Injury Service of the Veterans Affairs Palo Alto Medical Center (California, United States of America). The incidence of hypertension, dyslipidemia, insulin resistance, and the presence of metabolic syndrome were determined in 168 individuals with SCI (mean age 50.2 +/- 12.8 years). Fasting lipids, insulin, glucose, plasma homocysteine, and anthropometric data was gathered for each subject. Blood pressure values (P < 0.001) and mean arterial pressure (P < 0.05) increased with higher plasma homocysteine levels. Homocysteine values were also significantly greater among individuals with hypertension compared with those who were normotensive or prehypertensive (P < 0.0001). There was an inverse relationship between plasma homocysteine levels and glomerular filtration rate and effective renal plasma flow (P < 0.05). Plasma homocysteine levels are elevated in persons with SCI who have hypertension and inversely related to renal function, which suggests that renal dysfunction may be a link between homocysteine and hypertension in persons with SCI. Funded by the VA Rehabilitation Research and Development Service, Merit Review Grant #B2549R.