 |
 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
7 September 1999 | Volume 131 Issue 5 | Pages 352-355
Background: Total homocysteine levels are associated with arteriosclerotic outcomes.
Objective: To determine whether total homocysteine levels predict incident stroke in elderly persons.
Design: Prospective population-based cohort study with 9.9 years of follow-up.
Setting: Framingham, Massachusetts.
Patients: 1947 Framingham Study participants (1158 women and 789 men; mean age ± SD, 70 ± 7 years).
Measurements: Baseline total homocysteine levels and 9.9-year stroke incidence.
Results: The quartiles of nonfasting total homocysteine levels were as follows: quartile 1, 4.13 to 9.25 µmol/L; quartile 2, 9.26 to 11.43 µmol/L; quartile 3, 11.44 to 14.23 µmol/L; quartile 4, 14.24 to 219.84 µmol/L. During follow-up, 165 incident strokes occurred. In proportional hazards models adjusted for age, sex, systolic blood pressure, diabetes, smoking, and history of atrial fibrillation and coronary heart disease, relative risk (RR) estimates comparing quartile 1 with the other three quartiles were as follows: quartile 2 compared with quartile 1—RR, 1.32 (95% CI, 0.81 to 2.14); quartile 3 compared with quartile 1—RR, 1.44 (CI, 0.89 to 2.34); quartile 4 compared with quartile 1—RR, 1.82 (CI, 1.14 to 2.91). The linear trend across the quartiles was significant (P < 0.001).
Conclusion: Nonfasting total homocysteine levels are an independent risk factor for incident stroke in elderly persons.
Author and Article Information
From the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Boston University, Boston, Massachusetts; Memorial Hospital of Rhode Island, Providence, Rhode Island; and the National Heart, Lung, and Blood Institute's Framingham Study, Framingham, Massachusetts.
Grant Support: By U.S. Department of Agriculture contract 53-3K06-5-10; National Institutes of Health contract N01-HC-38038; National Heart, Lung, and Blood Institute grant RO1-HL-40423-05; and National Institute of Neurological Disorders and Stroke grant 2-RO1-NS-17950-17.
Requests for Reprints: Irwin H. Rosenberg, MD, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts New England Medical Center, 711 Washington Street, Boston, MA 02111; e-mail, rosenberg{at}hnrc.tufts.edu.
Current Author Addresses: Dr. Bostom: Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860.
Drs. Rosenberg, Jacques, and Selhub: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts New England Medical Center, 711 Washington Street, Boston, MA 02111.
Drs. Silbershatz and D'Agostino: Boston University, 111 Cummington Street, Boston, MA 02215.
Dr. Wilson: National Heart, Lung, and Blood Institute, 5 Thurber Street, Framingham, MA 01701.
Dr. Wolf: Boston University School of Medicine, 715 Albany Street, B608, Boston, MA 02118. BRIEF COMMUNICATION
Nonfasting Plasma Total Homocysteine Levels and Stroke Incidence in Elderly Persons: The Framingham Study
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  L.-C. Weng, W.-T. Yeh, C.-H. Bai, H.-J. Chen, S.-Y. Chuang, H.-Y. Chang, B.-F. Lin, K.-J. Chen, and W.-H. Pan Is Ischemic Stroke Risk Related to Folate Status or Other Nutrients Correlated With Folate Intake? Stroke, December 1, 2008; 39(12): 3152 - 3158. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Seshadri, P. A. Wolf, A. S. Beiser, J. Selhub, R. Au, P. F. Jacques, M. Yoshita, I. H. Rosenberg, R. B. D'Agostino, and C. DeCarli Association of Plasma Total Homocysteine Levels With Subclinical Brain Injury: Cerebral Volumes, White Matter Hyperintensity, and Silent Brain Infarcts at Volumetric Magnetic Resonance Imaging in the Framingham Offspring Study Arch Neurol, May 1, 2008; 65(5): 642 - 649. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Levy, S.-J. Hwang, A. Kayalar, E. J. Benjamin, R. S. Vasan, H. Parise, M. G. Larson, T. J. Wang, J. Selhub, P. F. Jacques, et al. Associations of Plasma Natriuretic Peptide, Adrenomedullin, and Homocysteine Levels With Alterations in Arterial Stiffness: The Framingham Heart Study Circulation, June 19, 2007; 115(24): 3079 - 3085. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-K. Kuo, K.-C. Liao, S. G. Leveille, J. F. Bean, C.-J. Yen, J.-H. Chen, Y.-H. Yu, and T.-Y. Tai Relationship of Homocysteine Levels to Quadriceps Strength, Gait Speed, and Late-Life Disability in Older Adults J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2007; 62(4): 434 - 439. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Nasir, M. Tsai, B. D. Rosen, V. Fernandes, D. A. Bluemke, A. R. Folsom, and J. A.C. Lima Elevated Homocysteine Is Associated With Reduced Regional Left Ventricular Function: The Multi-Ethnic Study of Atherosclerosis Circulation, January 16, 2007; 115(2): 180 - 187. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. J. Kullo, K. Ding, E. Boerwinkle, S. T. Turner, T. H. Mosley Jr, S. L.R. Kardia, and M. de Andrade Novel Genomic Loci Influencing Plasma Homocysteine Levels Stroke, July 1, 2006; 37(7): 1703 - 1709. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Selhub The Many Facets of Hyperhomocysteinemia: Studies from the Framingham Cohorts J. Nutr., June 1, 2006; 136(6): 1726S - 1730S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. F. Elias, L. M. Sullivan, R. B. D'Agostino, P. K. Elias, P. F. Jacques, J. Selhub, S. Seshadri, R. Au, A. Beiser, and P. A. Wolf Homocysteine and Cognitive Performance in the Framingham Offspring Study: Age Is Important Am. J. Epidemiol., October 1, 2005; 162(7): 644 - 653. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. L Tucker, N. Qiao, T. Scott, I. Rosenberg, and A. Spiro III High homocysteine and low B vitamins predict cognitive decline in aging men: the Veterans Affairs Normative Aging Study Am. J. Clinical Nutrition, September 1, 2005; 82(3): 627 - 635. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-K. Kuo, F. A. Sorond, J.-H. Chen, A. Hashmi, W. P. Milberg, and L. A. Lipsitz The Role of Homocysteine in Multisystem Age-Related Problems: A Systematic Review J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2005; 60(9): 1190 - 1201. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. B. Wright, M. C. Paik, T. R. Brown, S. P. Stabler, R. H. Allen, R. L. Sacco, and C. DeCarli Total Homocysteine Is Associated With White Matter Hyperintensity Volume: The Northern Manhattan Study Stroke, June 1, 2005; 36(6): 1207 - 1211. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. B. Sobol, E. Bald, and J. Loba Fractions of Total Plasma Homocysteine in Patients with Ischemic Stroke Before the Age of 55 Years Angiology, March 1, 2005; 56(2): 201 - 209. [Abstract] [PDF]
|
|
|
|
 |
|
 W. C. Winkelmayer, R. Kramar, G. C. Curhan, A. Chandraker, G. Endler, M. Fodinger, W. H. Horl, and G. Sunder-Plassmann Fasting Plasma Total Homocysteine Levels and Mortality and Allograft Loss in Kidney Transplant Recipients: A Prospective Study J. Am. Soc. Nephrol., January 1, 2005; 16(1): 255 - 260. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. W.F. Wilson CDC/AHA Workshop on Markers of Inflammation and Cardiovascular Disease: Application to Clinical and Public Health Practice: Ability of Inflammatory Markers to Predict Disease in Asymptomatic Patients: A Background Paper Circulation, December 21, 2004; 110(25): e568 - e571. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Sacco, K. Anand, H.-S. Lee, B. Boden-Albala, S. Stabler, R. Allen, and M. C. Paik Homocysteine and the Risk of Ischemic Stroke in a Triethnic Cohort: The Northern Manhattan Study Stroke, October 1, 2004; 35(10): 2263 - 2269. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. B. Wright, H. -S. Lee, M. C. Paik, S. P. Stabler, R. H. Allen, and R. L. Sacco Total homocysteine and cognition in a tri-ethnic cohort: The Northern Manhattan Study Neurology, July 27, 2004; 63(2): 254 - 260. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Iso, Y. Moriyama, S. Sato, A. Kitamura, T. Tanigawa, K. Yamagishi, H. Imano, T. Ohira, T. Okamura, Y. Naito, et al. Serum Total Homocysteine Concentrations and Risk of Stroke and Its Subtypes in Japanese Circulation, June 8, 2004; 109(22): 2766 - 2772. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. McKay, J. M. Berkowitz, J. B. Blumberg, and J. P. Goldberg Communicating Cardiovascular Disease Risk Due to Elevated Homocysteine Levels: Using the EPPM to Develop Print Materials Health Educ Behav, June 1, 2004; 31(3): 355 - 371. [Abstract] [PDF]
|
|
|
|
|
|
P. E. O'Suilleabhain, V. Sung, C. Hernandez, L. Lacritz, R. B. Dewey Jr, T. Bottiglieri, and R. Diaz-Arrastia Elevated Plasma Homocysteine Level in Patients With Parkinson Disease: Motor, Affective, and Cognitive Associations Arch Neurol, June 1, 2004; 61(6): 865 - 868. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. K. Al-Delaimy, K. M. Rexrode, F. B. Hu, C. M. Albert, M. J. Stampfer, W. C. Willett, and J. E. Manson Folate Intake and Risk of Stroke Among Women Stroke, June 1, 2004; 35(6): 1259 - 1263. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. L Tucker, B. Olson, P. Bakun, G. E Dallal, J. Selhub, and I. H Rosenberg Breakfast cereal fortified with folic acid, vitamin B-6, and vitamin B-12 increases vitamin concentrations and reduces homocysteine concentrations: a randomized trial Am. J. Clinical Nutrition, May 1, 2004; 79(5): 805 - 811. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Ray, A. S F Doney, and R. S MacWalter Secondary prevention for stroke and transient ischaemic attacks: Horizons needs expanding BMJ, April 10, 2004; 328(7444): 896 - 896. [Full Text]
|
|
|
|
|
|
S. G. Storey, V. Suryadevara, W. S. Aronow, and C. Ahn Association of Plasma Homocysteine in Elderly Persons With Atherosclerotic Vascular Disease and Dementia, Atherosclerotic Vascular Disease Without Dementia, Dementia Without Atherosclerotic Vascular Disease, and No Dementia or Atherosclerotic Vascular Disease J. Gerontol. A Biol. Sci. Med. Sci., December 1, 2003; 58(12): M1135 - 1136. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. D. Spotila, P. F. Jacques, P. B. Berger, K. V. Ballman, R. C. Ellison, and R. Rozen Age Dependence of the Influence of Methylenetetrahydrofolate Reductase Genotype on Plasma Homocysteine Level Am. J. Epidemiol., November 1, 2003; 158(9): 871 - 877. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X. Gao, M. Yao, M. A. McCrory, G. Ma, Y. Li, S. B. Roberts, and K. L. Tucker Dietary Pattern Is Associated with Homocysteine and B Vitamin Status in an Urban Chinese Population J. Nutr., November 1, 2003; 133(11): 3636 - 3642. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. V. Ostir, M. A. Raji, K. J. Ottenbacher, K. S. Markides, and J. S. Goodwin Cognitive Function and Incidence of Stroke in Older Mexican Americans J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2003; 58(6): M531 - 535. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. B. Fallon, J. Virtamo, I. Young, D. McMaster, Y. Ben-Shlomo, N. Wood, A. S. Whitehead, and G. D. Smith Homocysteine and Cerebral Infarction in Finnish Male Smokers Stroke, June 1, 2003; 34(6): 1359 - 1363. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Boysen, T. Brander, H. Christensen, R. Gideon, and T. Truelsen Homocysteine and Risk of Recurrent Stroke Stroke, May 1, 2003; 34(5): 1258 - 1261. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Tanne, M. Haim, U. Goldbourt, V. Boyko, R. Doolman, Y. Adler, D. Brunner, S. Behar, and B.-A. Sela Prospective Study of Serum Homocysteine and Risk of Ischemic Stroke Among Patients With Preexisting Coronary Heart Disease Stroke, March 1, 2003; 34(3): 632 - 636. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Rogers, A. Sanchez-Saffon, A. B. Frol, and R. Diaz-Arrastia Elevated Plasma Homocysteine Levels in Patients Treated With Levodopa: Association With Vascular Disease Arch Neurol, January 1, 2003; 60(1): 59 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
References Circulation, December 17, 2002; 106(25): 3373 - 3421. [Full Text]
|
|
|
|
 |
|
 J. Neugroschl and K. L. Davis Biological Markers in Alzheimer Disease Am J Geriatr Psychiatry, December 1, 2002; 10(6): 660 - 677. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. D. Bushnell and L. B. Goldstein Homocysteine testing in patients with acute ischemic stroke Neurology, November 26, 2002; 59(10): 1541 - 1546. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.-H. Yen and Y.-T. Lau Vascular Responses in Male and Female Hypertensive Rats With Hyperhomocysteinemia Hypertension, September 1, 2002; 40(3): 322 - 328. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Kelly, J. Rosand, J. P. Kistler, V. E. Shih, S. Silveira, A. Plomaritoglou, and K. L. Furie Homocysteine, MTHFR 677C->T polymorphism, and risk of ischemic stroke: Results of a meta-analysis Neurology, August 27, 2002; 59(4): 529 - 536. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. C.-K. Tan, N. Venketasubramanian, S.-M. Saw, and H. T.-L. Tjia Hyperhomocyst(e)inemia and Risk of Ischemic Stroke Among Young Asian Adults Stroke, August 1, 2002; 33(8): 1956 - 1962. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Niyikiza, S. D. Baker, D. E. Seitz, J. M. Walling, K. Nelson, J. J. Rusthoven, S. P. Stabler, P. Paoletti, A. H. Calvert, and R. H. Allen Homocysteine and Methylmalonic Acid: Markers to Predict and Avoid Toxicity from Pemetrexed Therapy Mol. Cancer Ther., May 1, 2002; 1(7): 545 - 552. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Symons, A. E. Mullick, J. L. Ensunsa, A. A. Ma, and J. C. Rutledge Hyperhomocysteinemia Evoked by Folate Depletion: Effects on Coronary and Carotid Arterial Function Arterioscler. Thromb. Vasc. Biol., May 1, 2002; 22(5): 772 - 780. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Gorelick Stroke Prevention Therapy Beyond Antithrombotics: Unifying Mechanisms in Ischemic Stroke Pathogenesis and Implications for Therapy: An Invited Review Stroke, March 1, 2002; 33(3): 862 - 875. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Seshadri, A. Beiser, J. Selhub, P. F. Jacques, I. H. Rosenberg, R. B. D'Agostino, P. W.F. Wilson, and P. A. Wolf Plasma Homocysteine as a Risk Factor for Dementia and Alzheimer's Disease N. Engl. J. Med., February 14, 2002; 346(7): 476 - 483. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S Ford, S J. Smith, D. F Stroup, K. K Steinberg, P. W Mueller, and S. B Thacker Homocyst(e)ine and cardiovascular disease: a systematic review of the evidence with special emphasis on case-control studies and nested case-control studies Int. J. Epidemiol., February 1, 2002; 31(1): 59 - 70. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. J. Howard, E. G. Sides, G. C. Newman, S. N. Cohen, G. Howard, M. R. Malinow, and J. F. Toole Changes in Plasma Homocyst(e)ine in the Acute Phase After Stroke Stroke, February 1, 2002; 33(2): 473 - 478. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.Y. Streifler, N. Rosenberg, A. Chetrit, R. Eskaraev, B.A. Sela, R. Dardik, A. Zivelin, B. Ravid, J. Davidson, U. Seligsohn, et al. Cerebrovascular Events in Patients With Significant Stenosis of the Carotid Artery Are Associated With Hyperhomocysteinemia and Platelet Antigen-1 (Leu33Pro) Polymorphism Stroke, December 1, 2001; 32(12): 2753 - 2758. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Matern and M. J. Magera Mass Spectrometry Methods for Metabolic and Health Assessment J. Nutr., May 1, 2001; 131(5): 1615S - 1620. [Abstract] [Full Text]
|
|
|
|
 |
|
 H. S. Friedman Serum Homocysteine and Stroke in Atrial Fibrillation Ann Intern Med, February 6, 2001; 134(3): 253 - 254. [Full Text] [PDF]
|
|
|
|
 |
|
 U B Fallon, P Elwood, Y Ben-Shlomo, J B Ubbink, R Greenwood, and G D. Smith Homocysteine and ischaemic stroke in men: the Caerphilly study J Epidemiol Community Health, February 1, 2001; 55(2): 91 - 96. [Abstract] [Full Text]
|
|
|
|
|
|
S.-M. Saw, J.-M. Yuan, C.-N. Ong, K. Arakawa, H.-P. Lee, G. A Coetzee, and M. C Yu Genetic, dietary, and other lifestyle determinants of plasma homocysteine concentrations in middle-aged and older Chinese men and women in Singapore Am. J. Clinical Nutrition, February 1, 2001; 73(2): 232 - 239. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B. Goldstein, R. Adams, K. Becker, C. D. Furberg, P. B. Gorelick, G. Hademenos, M. Hill, G. Howard, V. J. Howard, B. Jacobs, et al. Primary Prevention of Ischemic Stroke : A Statement for Healthcare Professionals From the Stroke Council of the American Heart Association Circulation, January 2, 2001; 103(1): 163 - 182. [Full Text] [PDF]
|
|
|
|
|
|
L. B. Goldstein, R. Adams, K. Becker, C. D. Furberg, P. B. Gorelick, G. Hademenos, M. Hill, G. Howard, V. J. Howard, B. Jacobs, et al. Primary Prevention of Ischemic Stroke : A Statement for Healthcare Professionals From the Stroke Council of the American Heart Association Stroke, January 1, 2001; 32(1): 280 - 299. [Full Text] [PDF]
|
|
|
|
|
|
D. L. McKay, G. Perrone, H. Rasmussen, G. Dallal, and J. B. Blumberg Multivitamin/Mineral Supplementation Improves Plasma B-Vitamin Status and Homocysteine Concentration in Healthy Older Adults Consuming a Folate-Fortified Diet J. Nutr., December 1, 2000; 130(12): 3090 - 3096. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Diaz-Arrastia Homocysteine and Neurologic Disease Arch Neurol, October 1, 2000; 57(10): 1422 - 1427. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. L. KASISKE, M. A. VAZQUEZ, W. E. HARMON, R. S. BROWN, G. M. DANOVITCH, R. S. GASTON, D. ROTH, J. D. SCANDLING JR., and G. G. SINGER Recommendations for the Outpatient Surveillance of Renal Transplant Recipients J. Am. Soc. Nephrol., October 1, 2000; 11(2007): S1 - S86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M Ueland, H. Refsum, S. A. Beresford, and S. E. Vollset The controversy over homocysteine and cardiovascular risk Am. J. Clinical Nutrition, August 1, 2000; 72(2): 324 - 332. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Homocysteine Associated with Stroke and Death Journal Watch Neurology, November 1, 1999; 1999(1101): 15 - 15. [Full Text]
|
|
|
|
 |
|
 Homocysteine and Stroke in the Elderly Journal Watch Cardiology, October 14, 1999; 1999(1014): 11 - 11. [Full Text]
|
|
|
|
 |
|
 Homocysteine Associated with Stroke and Death Journal Watch (General), September 17, 1999; 1999(917): 3 - 3. [Full Text]
|
|
Article
