Prehypertension is associated with oxidative stress and increased arterial stiffness. While plasma homocysteine levels are associated with increased pulse wave velocity (PWV) in hypertensive individuals, there is no report regarding this relationship in prehypertensives. The hypothesis for this study is that plasma homocysteine levels are independently associated with PWV in apparently healthy prehypertensive individuals. Homocysteine levels and brachial–ankle PWV (baPWV) were investigated in 4177 prehypertensives (3178 men, mean age 5311 years) with ABIs greater than 0.95 who had visited the Kangbuk Samsung Health Promotion Center. The subjects were subdivided into two groups according to baPWV; group I (1720 subjects) was defined as subjects with a baPWV of 1366cm/sec or lower, while group II (2457 subjects) included subjects with a baPWV greater than 1366cm/sec. Subjects were also divided into four quartile groups depending on homocysteine level; and the homocysteine levels in group II were found to be significantly higher than those in group I. There were significant differences in baPWV value among the four quartile groups (quartile I, 1411±213.9 cm/sec; quartile II, 1436±223.3 cm/sec; quartile III, 1460±220.4 cm/sec; quartile IV, 1494±251.3 cm/sec; p-value < 0.001). In multivariate regression models, the increasing homocysteine quartile groups were significantly associated with a higher odds ratio(ORs) for increased baPWV compared with that of the lowest group, irrespective of confounding factors including age, sex, metabolic syndrome, systolic BP, BMI, lifestyle status, hsCRP, heart rate, LDL cholesterol, and serum glucose(p for trend < 0.001): the highest quartile group showed high ORs for increased baPWV, compared with the lowest quartile group (ORs[95% CI], 1.96[1.54-2.49]). This study indicates an independent relationship between circulating homocysteine level and arterial stiffness in prehypertensives, suggesting that circulating homocysteine level could be a useful biomarker of subclinical target organ damage in prehypertensive individuals.
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