Circulation, Vol 87, 1107-1113, Copyright © 1993 by American Heart Association
MR Malinow, FJ Nieto, M Szklo, LE Chambless and G Bond
BACKGROUND. Plasma levels of homocyst(e)ine are elevated in certain
patients with occlusive arterial diseases. We extended these findings to
asymptomatic adults. METHODS AND RESULTS. We determined plasma
homocyst(e)ine levels in 287 pairs of asymptomatic adults. Cases and
controls were defined on the basis of intimal-medial thickness of the
carotid wall as measured by B-mode ultrasound. Study subjects had no
history of atherosclerotic disease and were selected from a probability
sample of 15,800 men and women between 45 and 64 years old. Subjects with
thickened intimal-medial carotid walls (cases) had higher plasma
homocyst(e)ine levels than controls (p < 0.001). The odds ratio for
having a thickened carotid artery wall was 3.15 (p < 0.001) for subjects
in the top quintile of plasma homocyst(e)ine levels (> 10.5 mumol/L)
compared with those in the bottom quintile (< 5.88 mumol/L).
CONCLUSIONS. The present study as well as observations on the common
occurrence of elevated plasma homocyst(e)ine levels in patients with
occlusive arterial diseases suggest that clinical trials should be
conducted to determine whether normalization of hyperhomocyst(e)inemia may
prevent progression of atherosclerosis.
ARTICLES
Carotid artery intimal-medial wall thickening and plasma homocyst(e)ine in asymptomatic adults. The Atherosclerosis Risk in Communities Study
Laboratory of Cardiovascular Diseases, Oregon Regional Primate Research Center, Beaverton 97006.
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