Elevated Homocysteine Concentrations Decrease the Antihypertensive Effect of Angiotensin-Converting Enzyme Inhibitors in Hypertensive Patients

• DOI: 10.1161/atvbaha.116.308515
• Publication Date: 2016-11-14T11:06:44Z
• Authors: Xianhui Qin; Youbao Li; Ningling Sun; Hong Wang; Yan Zhang; Jiguang Wang; Jianping Li; Xin Xu; Min Liang; Jing Nie; Binyan Wang; Xiaoshu Cheng; Nanfang Li; Yingxian Sun; Lianyou Zhao; Xiaobin Wang; Fan Fan Hou; Yong Huo
• Keywords: Male; China; Time Factors; Angiotensin-Converting Enzyme Inhibitors; Blood Pressure; Middle Aged; Up-Regulation; 3. Good health; 03 medical and health sciences; Folic Acid; Treatment Outcome; 0302 clinical medicine; Double-Blind Method; Enalapril; Hypertension; Humans; Female; Homocysteine; Antihypertensive Agents; Biomarkers; Aged

We aimed to examine whether baseline homocysteine (Hcy) concentrations affect antihypertensive responses enalapril treatment among previously untreated hypertensive patients (n=10 783) in the CSPPT (China Stroke Primary Prevention Trial).After a 3-week run-in with daily dose of 10 mg enalapril, eligible were randomly assigned double-blind tablet either (10 mg) and folic acid (0.8 or alone for median 4.5 years. After period alone, systolic blood pressure-lowering effect was significantly reduced by 1.39 (95% confidence interval 0.40-2.37) 3.25 1.98-4.52) mm Hg, respectively, those Hcy 15 ≥15 μmol/L (P trend <0.001) as compared concentration <10 μmol/L. Similar results observed after 15-week alone. 4.5-year enalapril-based period, μmol/L, still 0.77 0.01-1.53) 1.70 0.72-2.68) <0.001). In addition, participants higher had persistently pressure levels across entire study period. Similarly, inversely associated diastolic reduction during short-term treatment. However, inverse association between attenuated became insignificant long-term period.Elevated decreased patients.