Research Of The Relationship Of H-hypertension With Hemorrhagic Stroke

Object:1.To study the difference of Hcy and serum folate in hypertensive patientswith cerebral hemorrhage or with not,to explore the relationship of Hcy and serumfolate with hypertension cerebral hemorrhage.2. To investigate the frequency of the C677T polymorphism ofmethylenetetrahydrofolate reductase (MTHFR) genotypes and alletes,explicit therelationship of MTHFR gene polymorphism with hypertension cerebral hemorrhage.Method: We performed a case-control study with382cases of patients with essentialhypertension that hospitaled in our Cardiology and neurosurgery department fromMarch to September,2011. With CT/MRI diagnostic test whether cerebralhemorrhage,it’s divided into hypertension cerebral hemorrhage group and simplehypertension group. The plasma Hcy level was analyzed withhigh-performance liquidchromatography (HPLC).Hcy level≥10umol/l as high homocysteine(HHcy) standard,high bloodpressure associated with HHcy were classified as the H-hypertension347cases. Not with HHcy as non H hypertension35cases. Using chemiluminescencedetected plasma folate levels. With polymerase chain reaction restriction fragmentpolymorphism(PCR-RFLP) detected MTHFR gene C677T polymorphism.Results：1. The levels of the plasma homocysteine in the group of hypertension withcerebral hemorrhage were significantly higher than that in the simplehypertension[(21.56±10.75)umol/l] vs[(17.398±9.26)umol/l (P<0.05). The level of theHcy increased as the level of the folic acid reduced, both of them is with a significantnegative correlation[(r=-0.43,P<0.05)]. The level of the Hcy in man was higher thanin women[(22.18±11.59)umol/l] vs[(15.59±6.20)umol/l(P<0.05)](P<0.05). Theplasma Hcy levels in patients with smoking, drinking were significantly higher thanthat in no smoking, drinking. It has no obvious correlation between Hcy with age andblood fat (P>0.05).The probability of cerebral apoplexy in Hhypertension wassignificantly higher than in non H hypertension(49.3%vs31.4%,P<0.05)2. There were not obvious differences in frequenceies of their genotypes CC、CT、TTand alletes C、T between the two groups (P>0.05). Level of the plasma homocysteinein TT and CT genotypes were obvious higher than in CC genotypes. There were notobvious differences between TT genotype and CT genotype.There were different inthe factors of gender and body mass index in the three genotypes.3. Many factors logistic stepwise regression analysis showed that the independent riskfactors of the cerebral hemorrhage happened were higher Hcy(OR=1.07),systolicblood pressure(OR=1.03)and diatolic blood pressure (OR=1.05).Conclusion：1. H-hypertension patients has higher risk of cerebral hemorrhagic,Plasma Hcy may be linked to high blood pressure by additive interactions in the occurrence of hemorrhagic stroke.2. MTHFR gene polymorphism may be a susceptibility gene for plasma Hcy elevated,and it’s no coordination with hemorrhagic stroke in hypertensive patients.