Association of plasma homocysteine with morning blood pressure in patients with essential hypertension

Previous studies have shown that morning blood pressure elevation increases stroke risk. Homocysteine levels are linked to stroke, but the benefit of lowering them alone for stroke is unclear. We aimed to explore the correlation between plasma homocysteine levels and morning blood pressure. 1056 hypertensive patients who were hospitalized and received ambulatory blood pressure monitoring (ABPM) were enrolled in the study. Morning hypertension was defined as the average of blood pressure ≥135/85 mmHg during the morning period of ABPM recording. Spearman’s correlation analysis, logistic regression models, subgroup analysis were performed to investigate whether homocysteine levels were independently associated with morning hypertension. Both morning systolic blood pressure and diastolic blood pressure increased with the rise of homocysteine levels. Multivariate logistic regression analysis further determined that homocysteine levels were an independent risk factor for morning hypertension: with the lowest tertile group as a reference, middle tertile group: odds ratio (OR): 2.394, 95% confidence interval (CI): 1.554–3.687; highest tertile group: OR: 4.432, 95% CI: 2.549–7.706. The area under the receiver operating characteristic curve was 0.745. In subgroup analysis, it was found that the association of homocysteine levels with morning hypertension was stronger in hypertensive patients who were older than 60 years old, female, with BMI ≥ 25 kg/m², with a history of stroke. The plasma homocysteine levels are correlated with morning blood pressure in patients with essential hypertension, particularly among those who are older than 60 years, have a history of stroke, are female and have a BMI ≥ 25 kg/m². (Figure presented.)