Correlation Between Plasma Homocysteine Level And Left Ventricular Hypertrophy In Patients With Primary Hypertension

Objective:Because H-type hypertension has the characteristics of high incidence and high damage rate in our country,this topic using echocardiography to explore the correlation of plasma homocysteine (Hey) level and hypertrophy of left ventricle in primary hypertensive patients and to understand the influence of Hey heart structure in patients with primary hypertension.Methods:Selected a total of 376 cases of patients with primary hypertension in cardiology department from the GanMei Hospital of Kunming Medical University in May 2014 to October 2015,including 276 cases of patients with hyperhomocystinemia and 110 cases of patients with normal plasma homocysteine level.And than to selected 50 cases of hyperhomocystinemia patients without primary hypertension,and 30 cases of healthy people.Basic clinical characters were collected and plasma homocysteine level and erum lipid levels were measured.We applied the echocardiography to measure the cardiac structure and function indexs,such as left ventricular end-diastolic dimension(LVIDd)、interventricular septal thickness(IVST)、left ventricular posterior wall thickness(LVPWT) and to count left ventricular mass (LVM)and left ventricular mass index (LVMI).The relationship between plasma homocysteine level and left ventricular hypertrophy were analyzed.Results:1、In plasma Hey levels compare, H-type hypertension group and simple hyperhomocystinemia group, there was no significant difference (P> 0.05), but compared with non-H type hypertension group and healthy control group with significant difference (P< 0.05).2、There was no significant difference between the H-type hypertension group and the non-H type hypertension group in all kinds of antihypertensive drug applications (P> 0.05).3、Patients in H-type hypertension group、non-H type hypertension group and simple hyperhomocystinemia group had larger left ventricular end-diastolic dimension(LVIDd), larger interventricular septal thickness(IVST),larger left ventricular posterior wall thickness (LVPWT), increased left ventricular mass (LVM)and increased left ventricular mass index (LVMI)compared to those in healthy control, which H-type hypertension group increased more obviously (P<0.05)4、Except non-H type hypertension group and healthy control, patients in H-type hypertension group had larger LVIDd. IVST、LVPWT、LVM、LVMI and lower EF than non-H type hypertension group, more have significant differences (all P<0.05).5、The ratio of left ventricular hypertrophy was higher in H-type hypertension group than that in non-H type hypertension group (39.8% vs23.6%, x 2=8.98, P<0.05)6、Correlation analysis showed that Hcy was positively correlated with LVMI (r=0.25, P<0.05). Multivariable Logistic regression analysis showed that plasma Hcy levels was positively correlated with LVMI.Conclusions:High plasma Hcy level is correlated with the occurrence of left ventricular hypertrophy. In primary hypertensive patients, especially patients with hyperhomocystinemia are more likely to happen myocardial hypertrophy than the patients of non-H type hypertension,may be the synergy of HHcy and high blood pressure.