Hyperhomocysteinemia as a risk factor for ischemic stroke: an Indian scenario

Abstract

Background: Hyperhomocysteinemia has been proposed as an important risk factor for ischemic stroke worldwide, but data available from the Indian subcontinent is scarce. Aim: To study homocysteine levels in patients with ischemic stroke and compare it with age- and sex-matched controls. Settings and Design: Case-control prospective study. Materials and Methods: Fifty-seven patients with ischemic stroke and 30 controls were recruited for the study. They were subdivided into two subgroups (<40 years and >40 years of age) and plasma fasting total homocysteine (tHcy) levels were measured. Statistical analysis used: Student's 't' test and chi-square test. Results: The tHcy were significantly high in patients with stroke, compared to controls (9.91 ± 2.25 vs 8.00 ± 2.74 mmol/l; P < 0.001). Significantly high levels were seen in both male patients compared to controls (10.24 ± 2.34 vs 8.45 ± 2.72 mmol/l; P = 0.01) and female patients compared to controls (9.08 ± 1.81 vs 6.79 ± 2.60 mmol/l; P = 0.04). The tHcy levels were significantly high in patients with hypertension compared to normotensive patients (10.96 vs 9.49 mmol/l; P = 0.01) and smokers compared to nonsmokers (11.17 vs 9.33 mmol/l; P = 0.01). Conclusions: Hyperhomo-cysteinemia emerged as an important independent risk factor for ischemic stroke. A strong positive correlation was also observed between hypertension, smoking, and high-tHcy levels in the present study.