P-90: Hyperhomocysteinemia in hypertensive patients. Association with endothelial biochemical/functional alterations

Introduction: The prevalence of hyperhomocysteinemia is 10-20% over general population. This rate outstandingly increases in patients with classical cardiovascular risk factors (CVRF). Prevalence of hyperhomocysteinemia among hypertensive patients is higher. Aims: 1-Evaluate the prevalence of hyperhomocysteinemia among the elevated cardiovascular risk population. 2-Determine if homocysteine (Hcy) levels have a correlation with average blood pressure. 3-Study biochemical and functional endothelial alterations in hyperhomocysteinemic patients. Patients and Methods: N=129(66 M, 63 F), aged 21 to 83 years(62 ± 12): 81 hypertensive, 50 type 2 diabetic and 61 dislipemic. 24 h Holter: Spacelabs 90207. Doppler-ultrasonography: HP Imagepointx. Endothelial Dependent Vasodilatation(EDV) was evaluated by Flow mediated vasodilatation and assessed by post-ischemic brachial artery flow increase. Endothelial Independent Vasodilatation(EIDV) was evaluated by brachial artery flow increase after sublingual nitroglycerine administration. PAI-1 (ng/ml) ELISA Menarini; Hcy(uM/L): IMX Abbott; Statistical analysis: Linear Regression, Fisher test, T-Student and Mann-Whitney test. In N=44 patients 24 h blood pressure Holter was correlated to Hcy. ED was evaluated by brachial doppler in N= 48 patients with Hcy ≥ 12 uM/L. Results: 1-Hcy≥12uM/L in 87,6% hypertensive patients, 82% type 2 diabetics and 83,6% dislipemics. 2-There is a positive lineal correlation between Hcy levels and average 24h diastolic blood pressure(r=0,33, p=0,045). 3-60,5% of the patients with Hcy≥12 uM/L suffer from Doppler endothelial dysfunction(ED). 4-Patients with Hcy≥12 uM/L had a PAI-1 of 51,91±3,24 ng/dl(SEM) vs patients with Hcy