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Elevated Levels of Plasma Homocysteine in Hypertensive Patients with Diabetes Mellitus

Department of Pathology, College of Medicine, University of Saskatchewan, Saskatoon, Canada; Royal University Hospital, College of Medicine, University of Saskatchewan, Saskatoon, Canada

Hasnain Khsandwala, MD

Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada; Royal University Hospital, College of Medicine, University of Saskatchewan, Saskatoon, Canada

Inam Ul Haq, PhD

Department of Pathology, College of Medicine, University of Saskatchewan, Saskatoon, Canada

Kailash Prasad, MD, PhD

Department of Physiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada; prasadk{at}sask.usask.ca

Background: Homocysteine generates oxygen radicals (superoxide anion and hydrogen peroxide) that are known to produce vasoconstriction. Hypertension is a common problem in individuals with diabetes mellitus. It is possible that hypertension in diabetic patients may be due to increased levels of plasma homocysteine. We investigated the plasma levels of homocysteine, factors involved in homocysteine metabolism (serum folic acid and vitamin B₁₂) and lipid peroxidation product in the serum of diabetic patients with hypertension.

Methods and Results: The studies were conducted in three groups: 1) healthy controls, and diabetic patients who were 2) normotensive and 3) hypertensive. Plasma homocysteine, serum malondialdehyde (a lipid peroxidation product), vitamin B₁₂, and folic acid were measured in these patients. Plasma homocysteine and serum malondialdehyde levels were elevated in diabetic patients compared to the control group. Plasma levels of homocysteine and serum levels of malondialdehyde were higher in the hypertensive diabetic patients than in those who were normotensive. Levels of serum folate were lower in hypertensive diabetic patients compared to the normotensive group. Levels of serum vitamin B₁₂ were similar in both the normotensive and hypertensive diabetic patients.

Conclusions: Levels of plasma homocysteine and serum malondialdehyde are elevated in hypertensive diabetic patients. Hyperhomocysteinemia may be involved in the induction and sustaining of hypertension in diabetic patients.

Key Words: diabetes • hypertension • hyperhomocysteinemia • malondialdehyde • folic acid • vitamin B12

Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 8, No. 4, 261-266 (2003)
DOI: 10.1177/107424840300800403


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