Associations of Serum and Red Blood Cell Folate With All-Cause and Cardiovascular Mortality Among Hypertensive Patients With Elevated Homocysteine - PubMed (original) (raw)
Associations of Serum and Red Blood Cell Folate With All-Cause and Cardiovascular Mortality Among Hypertensive Patients With Elevated Homocysteine
Long Zhou et al. Front Nutr. 2022.
Abstract
Objectives: This study aims to explore the associations between serum and red blood cell (RBC) folate as indicators of short- and long-term folate status, respectively, and all-cause as well as CVD mortality among hypertensive patients with elevated homocysteine.
Methods: A prospective cohort study of the National Health and Nutrition Examination Survey (1999-2006) and 2015 Linked Mortality File was performed. All-cause and CVD mortality risk estimated using Cox proportional hazards models with adjusting for multiple potential covariates.
Results: A total of 1,753 hypertensive patients with elevated homocysteine [mean (SD) age, 68.5 (13.1)] were included in the analysis. During a median follow-up of 10.0 years, a total of 899 all-cause and 257 CVD deaths occurred. Compared the highest with the lowest quartile of RBC folate, the multivariable adjusted hazard ratios and 95% confidence intervals for all-cause and CVD death were 1.13 (0.92-1.39) and 1.47 (1.01-2.16) respectively. There was a significant and positive trend between RBC folate and the risk of CVD death (p for trend = 0.0196). No significant association was found between serum folate and mortality risk among the study sample.
Conclusions: High level of RBC folate is associated with an increased risk of cardiovascular mortality among hypertensive patients with elevated homocysteine while serum folate has no such effects.
Keywords: homocysteine; hypertension; mortality; red blood cell; serum folate.
Copyright © 2022 Zhou, Huang, Wen, Chen, Liao, Chen, Zhao, Liu, Tao and Li.
Conflict of interest statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Figures
Figure 1
Flowchart of the study population selection.
Figure 2
Kaplan-Meier curves of all-cause and cardiovascular disease (CVD) death by baseline quartiles of serum folate.
Figure 3
Kaplan-Meier curves of all-cause and cardiovascular disease (CVD) death by baseline quartiles of red blood cell (RBC) folate.
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