Higher Rates of CV Events, Death Among OAs With High Homocysteine

High blood levels of homocysteine were significantly associated with cardiovascular disease events and all-cause death in older adults who did not have a history of ischemia or congestive heart failure. Researchers published their findings in the journal Therapeutics and Clinical Risk Management.

“Although it is still debatable whether homocysteine is a causal factor or a marker of cardiovascular disease and mortality,” they wrote, “evidence from previous studies had confirmed our findings that serum total homocysteine concentrations are predictive of cardiovascular disease and/or mortality.”

The community-based prospective cohort study included 1257 older adults living in Beijing. Participants were age 55 or older, with an average age of 69. Over approximately 5 years of follow-up, 173 cardiovascular disease events occurred, 12.3% of participants died, and 40% of the deaths were from cardiovascular disease.  

Compared with participants with normal homocysteine levels, those with intermediate-to-severe homocysteine levels were at higher risk of all-cause and cardiovascular disease death, according to the study. Researchers reported hazard ratios of 1.68 for cardiovascular events, 1.97 for cardiovascular death, and 2.02 for all-cause death with intermediate-to-severe homocysteine levels. Every 5μmol/L increment in homocysteine concentration, they added, was associated with a 4% higher risk of cardiovascular disease events and 5% higher risk of all-cause death. 

Positive associations were particularly pronounced in men. 

“We found that elevated homocysteine level increased the risks of cardiovascular disease events and all-cause death in males, but not in females,” researchers wrote. “ In addition, males or elders were likely to have higher homocysteine levels than females or younger participants.”

—Jolynn Tumolo

Reference:

Zhang Z, Gu X, Fang X, et al. Homocysteine and the Risk of Cardiovascular Events and All-Cause Death in Elderly Population: A Community-Based Prospective Cohort Study. Ther Clin Risk Manag. 2020;16:471-481. Published 2020 May 22. doi:10.2147/TCRM.S239496