J Epidemiol Community Health 2001;55:91-96 ( February )

Research report

Homocysteine and ischaemic stroke in men: the Caerphilly study U B Fallon^a, P Elwood^b, Y Ben-Shlomo^a, J B Ubbink^c, R Greenwood^a, G Davey Smith^a

^a Department of Social Medicine, University of Bristol, Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK, ^b MRC Epidemiology Unit, Llandough Hospital, Penarth, South Glamorgan, ^c University of Pretoria, Department of Chemical Pathology, Faculty of Medicine, Pretoria, South Africa

Correspondence to: Dr Fallon (una.fallon{at}bristol.ac.uk)

Accepted for publication 14 September 2000

OBJECTIVETo assess the risk of ischaemic stroke associated with total serum homocyst(e)ine (tHcy) concentration.
DESIGNCohort study.
SETTINGCaerphilly, South Wales
PARTICIPANTS2254 men age 50 to 64 years recruited between 1984 and 1988.
RESULTS107 men developed ischaemic stroke and mean follow up time was 10.2 years. There was no significant difference in mean serum total homocyst(e)ine levels between stroke cases (12.2 µmol 95% CI 11.6 to 13.1) and non-cases (11.7 µmol 95% CI 11.5 to 11.9) (p=0.14). There was no significant risk for a standard deviation increase in homocyst(e)ine (adjusted hazard ratio = 1.1, 95% CI 0.9 to 1.4). An interaction was observed between homocyst(e)ine and age at entry (p=0.003). The adjusted odds ratio comparing the top quintile of homocyst(e)ine with the rest was 2.5 (95% CI 1.0 to 6.2) for strokes occurring under 65 years and 0.5 (95% CI 0.2 to 1.3) at 65 years or older (p value for interaction =0.02). Risk also differed by blood pressure status. The adjusted hazard ratio for a standard deviation increase in homocyst(e)ine was 0.8, (95% CI 0.6 to 1.2) for normotensive men and 1.3 (95% CI 1.1 to 1.7) for hypertensive men (p value for interaction =0.01).
CONCLUSIONSOverall, there is no significant relation between homocyst(e)ine and ischaemic stroke in this cohort. However, its aetiological importance may be greater for premature ischaemic strokes (<65 years) and in hypertensive men.


Keywords: homocyst(e)ine; ischaemic stroke; cohort

---

© 2001 by Journal of Epidemiology and Community Health
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Nasir, K., Tsai, M., Rosen, B. D., Fernandes, V., Bluemke, D. A., Folsom, A. R., Lima, J. A.C. (2007). Elevated Homocysteine Is Associated With Reduced Regional Left Ventricular Function: The Multi-Ethnic Study of Atherosclerosis. Circulation 115: 180-187 [Abstract] [Full Text]  
• Poli, D., Antonucci, E., Cecchi, E., Marcucci, R., Liotta, A. A., Cellai, A. P., Lenti, M., Gensini, G. F., Abbate, R., Prisco, D. (2005). Culprit Factors for the Failure of Well-Conducted Warfarin Therapy to Prevent Ischemic Events in Patients With Atrial Fibrillation: The Role of Homocysteine. Stroke 36: 2159-2163 [Abstract] [Full Text]  
• Tucker, K. L, Qiao, N., Scott, T., Rosenberg, I., Spiro, A. III (2005). High homocysteine and low B vitamins predict cognitive decline in aging men: the Veterans Affairs Normative Aging Study. Am. J. Clin. Nutr. 82: 627-635 [Abstract] [Full Text]  
• Martin, R. M, Ben-Shlomo, Y., Gunnell, D., Elwood, P., Yarnell, J. W G, Davey Smith, G. (2005). Breast feeding and cardiovascular disease risk factors, incidence, and mortality: the Caerphilly study. J. Epidemiol. Community Health 59: 121-129 [Abstract] [Full Text]  
• Tyagi, S. C., Rodriguez, W., Patel, A. M., Roberts, A. M., Falcone, J. C., Passmore, J. C., Fleming, J. T., Joshua, I. G. (2005). Hyperhomocysteinemic Diabetic Cardiomyopathy: Oxidative Stress, Remodeling, and Endothelial-Myocyte Uncoupling. J CARDIOVASC PHARMACOL THER 10: 1-10 [Abstract]  
• Sacco, R. L., Anand, K., Lee, H.-S., Boden-Albala, B., Stabler, S., Allen, R., Paik, M. C. (2004). Homocysteine and the Risk of Ischemic Stroke in a Triethnic Cohort: The Northern Manhattan Study. Stroke 35: 2263-2269 [Abstract] [Full Text]  
• Al-Delaimy, W. K., Rexrode, K. M., Hu, F. B., Albert, C. M., Stampfer, M. J., Willett, W. C., Manson, J. E. (2004). Folate Intake and Risk of Stroke Among Women. Stroke 35: 1259-1263 [Abstract] [Full Text]  
• Babisch, W, Ising, H, Gallacher, J E J (2003). Health status as a potential effect modifier of the relation between noise annoyance and incidence of ischaemic heart disease. Occup. Environ. Med. 60: 739-745 [Abstract] [Full Text]  
• Fallon, U. B., Virtamo, J., Young, I., McMaster, D., Ben-Shlomo, Y., Wood, N., Whitehead, A. S., Smith, G. D. (2003). Homocysteine and Cerebral Infarction in Finnish Male Smokers. Stroke 34: 1359-1363 [Abstract] [Full Text]  
• Boysen, G., Brander, T., Christensen, H., Gideon, R., Truelsen, T. (2003). Homocysteine and Risk of Recurrent Stroke. Stroke 34: 1258-1261 [Abstract] [Full Text]  
• Tanne, D., Haim, M., Goldbourt, U., Boyko, V., Doolman, R., Adler, Y., Brunner, D., Behar, S., Sela, B.-A. (2003). Prospective Study of Serum Homocysteine and Risk of Ischemic Stroke Among Patients With Preexisting Coronary Heart Disease. Stroke 34: 632-636 [Abstract] [Full Text]  
• De Bree, A., Verschuren, W. M., Kromhout, D., Mennen, L. I, Blom, H. J, Ford, E. S, Smith, S J., Stroup, D. F, Steinberg, K. K, Mueller, P. W, Thacker, S. B (2002). Homocysteine and coronary heart disease: the importance of a distinction between low and high risk subjects. Int J Epidemiol 31: 1268-1272 [Full Text]  
• Kelly, P. J., Rosand, J., Kistler, J. P., Shih, V. E., Silveira, S., Plomaritoglou, A., Furie, K. L. (2002). Homocysteine, MTHFR 677C->T polymorphism, and risk of ischemic stroke: Results of a meta-analysis. Neurology 59: 529-536 [Abstract] [Full Text]