Association of Homocysteine with Cardiac Remodeling in Hypertension

Objective. The study aimed to investigate the relationship between plasma homocysteine (HC) concentration, blood lipid metabolism parameters, and the structural and functional state of the cardiovascular system in patients with arterial hypertension (AH), depending on its severity.Material and Methods. To assess the relationship between homocysteine (HC) levels and changes in the walls of the common carotid arteries (CCA), 51 patients with AH of varying severity were examined. The patients were divided into two subgroups according to plasma HC levels. Hyperhomocysteinemia (HHC) was diagnosed when HC levels exceeded 15 μmol/L (normal range: 5–15 μmol/L). Depending on the severity of HHC, patients were further divided into three subgroups: HC levels of 15–30 μmol/L (mild HHC), 30–100 μmol/L (moderate HHC), and more than 100 μmol/L (severe HHC). To address the study objectives, blood homocysteine levels were measured, along with lipid profile parameters; cardiac functional status was assessed by echocardiography; the structural and functional state of the common carotid arteries (CCA) was evaluated using ultrasound.Results. HC levels were within the normal range in 31 patients (60.8 ± 6.8%) and exceeded normal values in 20 patients (39.2 ± 6.8%). Among the 20 patients with HHC, 13 (25.5 ± 6.1%) had mild HHC and 7 (13.7 ± 4.8%) had moderate HHC. No cases of severe HHC were observed. According to one-way analysis of variance (ANOVA), the difference in HC levels between these groups was statistically significant (F = 127.444; p < 0.0001). Significant differences were also identified using the Kruskal–Wallis test (χ² = 36.477; p < 0.0001).Conclusion. The present study demonstrates that hyperhomocysteinemia is common among patients with arterial hypertension and is associated with unfavorable cardiovascular structural and functional alterations. As homocysteine levels increased, there was a consistent tendency toward more severe arterial hypertension, higher blood pressure parameters, impaired diastolic function, reduced left ventricular ejection fraction, and a greater prevalence of vascular remodeling reflected by increased carotid intima–media thickness.