Hyperhomocysteinemia as a risk factor for ischemic stroke: An Indian scenario

Background : Hyperhomocysteinemia has been proposed as an important risk factor for ischemic stroke worldwide, but data available from the Indian subcontinent is scarce. Aim : To study homocysteine levels in patients with ischemic stroke and compare it with age- and sex-matched controls. Settings and Design: Case-control prospective study. Materials and Methods: Fifty-seven patients with ischemic stroke and 30 controls were recruited for the study. They were subdivided into two subgroups (40 years of age) and plasma fasting total homocysteine (tHcy) levels were measured. Statistical analysis used: Student′s ′t′ test and chi-square test. Results: The tHcy were significantly high in patients with stroke, compared to controls (9.91 ± 2.25 vs 8.00 ± 2.74 mmol/l; P < 0.001). Significantly high levels were seen in both male patients compared to controls (10.24 ± 2.34 vs 8.45 ± 2.72 μmol/l; P = 0.01) and female patients compared to controls (9.08 ± 1.81 vs 6.79 ± 2.60 μmol/l; P = 0.04). The tHcy levels were significantly high in patients with hypertension compared to normotensive patients (10.96 vs 9.49 μmol/l; P = 0.01) and smokers compared to nonsmokers (11.17 vs 9.33 μol/l; P = 0.01). Conclusions : Hyperhomo-cysteinemia emerged as an important independent risk factor for ischemic stroke. A strong positive correlation was also observed between hypertension, smoking, and high-tHcy levels in the present study.