Homocysteine levels and risk of essential hypertension: A meta-analysis of published epidemiological studies

Abstract

Background: Plasma homocysteine (Hcy) levels may be associated with essential hypertension (EH). However, the results of previous studies on this association are inconsistent.Methods: In this meta-analysis, we performed a systematic literature search of the Embase, PubMed, Cochrane Library, and Web of Science for the relevant articles dated up to March 2016. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to evaluate the estimates.Results: We included 11 studies with a total of 16,571 participants (4,830 EH cases). We found that elevated Hcy levels were associated with the risk of EH (pooled OR: 1.36, 95% CI: 1.02–1.80 in the random-effects model). However, subsequent subgroup analyses showed that elevated Hcy levels increased the EH risk in retrospective studies (OR: 1.82, 95% CI: 1.53–2.16; p < 0.001) and unadjusted studies (OR: 1.72, 95% CI: 1.43–2.07; p < 0.001), but not in perspective studies (OR: 0.99, 95% CI: 0.73–1.28; p = 0.939) and adjusted studies (OR: 1.21, 95% CI: 0.85–1.72; p = 0.297). No significant publication bias was found (p = 0.876 for Begg’s test, p = 0.144 for Egger’s test).Conclusion: Plasma Hcy levels are associated with EH risk. However, our findings do not support a causal association between Hcy levels and EH.

Keywords

• epidemiological study
• essential hypertension
• homocysteine
• odds ratio
• meta-analysis