Study design: Cross-sectional analysis of a convenience sample of locally recruited participants, including both patients and volunteers.
Objectives: To determine whether there is an association between plasma homocysteine and hypertension in persons with spinal cord injury (SCI).
Setting: Spinal Cord Injury Service of the Veterans Affairs Palo Alto Medical Center (California, United States of America).
Methods: The incidence of hypertension, dyslipidemia, insulin resistance, and the presence of metabolic syndrome were determined in 168 individuals with SCI (mean age 50.2 +/- 12.8 years). Fasting lipids, insulin, glucose, plasma homocysteine, and anthropometric data was gathered for each subject.
Results: Blood pressure values (P < 0.001) and mean arterial pressure (P < 0.05) increased with higher plasma homocysteine levels. Homocysteine values were also significantly greater among individuals with hypertension compared with those who were normotensive or prehypertensive (P < 0.0001). There was an inverse relationship between plasma homocysteine levels and glomerular filtration rate and effective renal plasma flow (P < 0.05).
Conclusions: Plasma homocysteine levels are elevated in persons with SCI who have hypertension and inversely related to renal function, which suggests that renal dysfunction may be a link between homocysteine and hypertension in persons with SCI.
Sponsorship: Funded by the VA Rehabilitation Research and Development Service, Merit Review Grant #B2549R.