Association of total homocysteine with blood pressure in a general population of Chinese adults: a cross-sectional study in Jiangsu province, China

Objectives We aimed to evaluate the relation of total homocysteine (tHcy) concentrations with systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels, and examine the possible modifiers in the association among a general population of Chinese adults. Design A cross-sectional study. Setting The study was conducted within 21 communities in Lianyungang of Jiangsu province, China. Participants A total of 26648 participants aged >= 35 years and with no antihypertensive drug use were included in the final analysis. Results Overall, there was a positive association between tHcy concentrations and SBP (per 5 mu mol/L tHcy increase: adjusted beta=0.45mm Hg; 95%CI 0.29 to 0.61) or DBP levels (per 5 mu mol/L tHcy increase: adjusted beta=0.47mm Hg; 95% CI 0.35 to 0.59). Compared with participants with tHcy <10 mu mol/L, significantly higher SBP levels were found in those with tHcy concentrations of 10 to <15 (adjusted beta=0.80 mm Hg; 95% CI 0.32 to 1.28) and >= 15 mu mol/L (adjusted beta=1.79 mm Hg; 95% CI 1.20 to 2.37; p for trend <0.001). Consistently, significantly higher DBP levels were found in participants with tHcy concentrations of 10 to <15 (adjusted beta=0.86 mm Hg; 95% CI 0.49 to 1.22) and >= 15 mu mol/L (adjusted beta=2.01 mm Hg; 95% CI 1.57 to 2.46; p for trend <0.001), respectively as compared with those with <10 mu mol/L. Furthermore, a stronger association between tHcy and SBP (p for interaction=0.009) or DBP (p for interaction=0.067) was found in current alcohol drinkers. Conclusion Serum tHcy concentrations were positively associated with both SBP and DBP levels in a general Chinese adult population. The association was stronger in current alcohol drinkers.