| Title | Elevated Homocysteine Concentrations Decrease the Antihypertensive Effect of Angiotensin-Converting Enzyme Inhibitors in Hypertensive Patients |
| Authors | Qin, Xianhui Li, Youbao Sun, Ningling Wang, Hong Zhang, Yan Wang, Jiguang Li, Jianping Xu, Xin Liang, Min Nie, Jing Wang, Binyan Cheng, Xiaoshu Li, Nanfang Sun, Yingxian Zhao, Lianyou Wang, Xiaobin Hou, Fan Fan Huo, Yong |
| Affiliation | Southern Med Univ, Div Renal, Nanfang Hosp, Natl Clin Res Ctr Kidney Dis,State Key Lab Organ, Guangzhou, Guangdong, Peoples R China. Peking Univ Peoples Hosp, Dept Cardiol, Beijing, Peoples R China. Temple Univ, Ctr Metab Dis Res, Sch Med, Philadelphia, PA 19122 USA. Peking Univ First Hosp, Dept Cardiol, Beijing, Peoples R China. Shanghai Jiao Tong Univ, Ctr Epidemiol Studies & Clin Trials, Sch Med, Ruijin Hosp, Shanghai 200030, Peoples R China. Shanghai Jiao Tong Univ, Ctr Vasc Evaluat, Sch Med, Shanghai Inst Hypertens,Shanghai Key Lab Hyperten, Shanghai 200030, Peoples R China. Nanchang Univ, Affiliated Hosp 2, Dept Cardiol, Nanchang, Jiangxi, Peoples R China. Peoples Hosp Xinjiang Uygur Autonomous Reg, Dept Hypertens, Ctr Diag Treatment & Res Hypertens Xinjiang, Urumqi, Peoples R China. China Med Univ, Dept Cardiovasc Med, Hosp 1, Shenyang, Peoples R China. Fourth Mil Med Univ, Tangdu Hosp, Dept Cardiol, Xian, Peoples R China. Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Populat Family & Reprod Hlth, Baltimore, MD USA. Southern Med Univ, Div Renal, Nanfang Hosp, Natl Clin Res Ctr Kidney Dis,State Key Lab Organ, Guangzhou, Guangdong, Peoples R China. Huo, Y (reprint author), Peking Univ Peoples Hosp, Dept Cardiol, Beijing, Peoples R China. |
| Keywords | antihypertensive responses enalapril-based antihypertensive treatment folic acid therapy homocysteine concentrations hypertension CYSTATHIONINE BETA-SYNTHASE FOLIC-ACID SUPPLEMENTATION ARTERY STIFFNESS DEFICIENT MICE BLOOD-PRESSURE FOLATE INTAKE HYPERHOMOCYSTEINEMIA ADULTS TRIAL ATHEROSCLEROSIS |
| Issue Date | 2017 |
| Publisher | ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY |
| Citation | ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY.2017,37(1),166-+. |
| Abstract | Objective-We aimed to examine whether baseline homocysteine (Hcy) concentrations affect antihypertensive responses to enalapril treatment among previously untreated hypertensive patients (n=10 783) in the CSPPT (China Stroke Primary Prevention Trial). Approach and Results-After a 3-week run-in treatment with a daily dose of 10 mg enalapril, eligible hypertensive patients were randomly assigned to a double-blind daily treatment of a tablet of either enalapril (10 mg) and folic acid (0.8 mg) or enalapril (10 mg) alone for a median of 4.5 years. After the 3-week treatment period with enalapril alone, the systolic blood pressure-lowering effect was significantly reduced by 1.39 (95% confidence interval 0.40-2.37) and 3.25 (95% confidence interval 1.98-4.52) mm Hg, respectively, in those with baseline Hcy concentrations of 10 to 15 and >= 15 mu mol/L (P for trend <0.001) as compared with those with Hcy concentration of < 10 mu mol/L. Similar results were observed after a 15-week treatment period with enalapril alone. After a median 4.5-year enalapril-based antihypertensive treatment period, compared with those with Hcy concentration of < 10 mu mol/L, the systolic blood pressure-lowering effect was still significantly reduced by 0.77 (95% confidence interval 0.01-1.53) and 1.70 (95% confidence interval 0.72-2.68) mm Hg, respectively, in those with Hcy concentrations of 10 to 15 and >= 15 mu mol/L (P for trend <0.001). In addition, participants with higher baseline Hcy concentrations had persistently higher systolic blood pressure levels across the entire study treatment period. Similarly, baseline Hcy concentrations were inversely associated with diastolic blood pressure reduction during the short-term enalapril alone treatment. However, the inverse association between baseline Hcy and diastolic blood pressure reduction was attenuated and became insignificant after the long-term enalapril-based treatment period. Conclusions-Elevated Hcy concentrations significantly decreased the antihypertensive effect of the short-term and long-term enalapril-based antihypertensive treatment in previously untreated hypertensive patients. |
| URI | http://hdl.handle.net/20.500.11897/476460 |
| ISSN | 1079-5642 |
| DOI | 10.1161/ATVBAHA.116.308515 |
| Indexed | SCI(E) |
| Appears in Collections: | 人民医院 第一医院 |
