Information on the association between homocysteine (HCY) levels and carotid atherosclerosis (CAS) in hypertension (HTN) is limited. A cross-sectional study was performed to examine the relationship of plasma HCY concentration with CAS in 1700 hypertensives (61.62 ± 12.16 year). The prevalence of CAS and carotid intima-media thickness (CIMT) progressively increased across quartiles of HCY levels (P < 0.001). Correlation analysis showed significantly positive correlation between HCY and CAS (r = 0.261, P < 0.001). In a logistic regression, HCY independently predicted the presence of CAS (OR 1.284, 95% CI 1.163-1.418). Further investigation revealed that interaction effect of HCY was substantial for gender (P for interaction 0.023), age (P for interaction <0.001) and smoking (P for interaction 0.025) on CAS. Thus, in hypertensives, those of male, aged ≥55 year and current smokers, in which HCY ≥ 13.49 μmol/L were more likely to suffer CAS, suggesting a role of HCY in the development and progression of CAS in these patients, and HCY determination should be recommended to better stratify the cardiovascular risk.
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