PMID- 29678422
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 1878-7436 (Electronic)
IS  - 1878-7436 (Linking)
VI  - 12
IP  - 7
DP  - 2018 Jul
TI  - Significant interaction of hypertension and homocysteine on neurological severity 
      in first-ever ischemic stroke patients.
PG  - 534-541
LID - S1933-1711(18)30088-3 [pii]
LID - 10.1016/j.jash.2018.03.011 [doi]
AB  - It is not known whether combination of hypertension and high homocysteine (HHcy) 
      impacts on stroke-related neurological severity. Our aim was to determine whether 
      there is an interaction of hypertension and HHcy on neurological severity in 
      first-ever ischemic stroke patients. We analyzed neurological severity among 189 
      consecutive first-ever ischemic stroke patients with or without hypertension or 
      HHcy. Hypertension (odds ratio [OR]: 8.086, 95% confidence interval [CI]: 
      3.596-18.181, P < .001) and total homocysteine (OR: 1.403, 95% CI: 1.247-1.579, 
      P < .001) were independently associated with neurological severity. In 
      receiver-operating characteristic analysis, total homocysteine was a significant 
      predictor of neurological severity (area under curve: 0.794; P < .001). A 
      multiplicative interaction of hypertension and HHcy on more severe neurological 
      severity was revealed by binary logistic regression (OR: 13.154, 95% CI: 
      5.293-32.691, P < .001). Analysis further identified a more than multiplicative 
      interaction of hypertension and HHcy on neurological severity compared with 
      patients without each condition (OR: 50.600, 95% CI: 14.775-173.285, P < .001). 
      Interaction effect measured on an additive scale showed that 76.4% patients with 
      moderate/severe neurological severity were attributed to interaction of 
      hypertension and HHcy. Significant interaction of hypertension and HHcy on 
      neurological severity was found on multiplicative and additive scale in 
      first-ever Chinese ischemic stroke patients.
CI  - Copyright (c) 2018 American Heart Association. Published by Elsevier Inc. All 
      rights reserved.
FAU - Fan, Ying-Li
AU  - Fan YL
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, Jiangxi, China.
FAU - Zhan, Rui
AU  - Zhan R
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, Jiangxi, China.
FAU - Dong, Yi-Fei
AU  - Dong YF
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, Jiangxi, China; Key Laboratory of Molecular Biology in 
      Jiangxi Province, Nanchang, Jiangxi, China. Electronic address: 
      yf_dong66@126.com.
FAU - Huang, Lei
AU  - Huang L
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, Jiangxi, China.
FAU - Ji, Xi-Xin
AU  - Ji XX
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, Jiangxi, China.
FAU - Lu, Peng
AU  - Lu P
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, Jiangxi, China.
FAU - Liu, Jian
AU  - Liu J
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, Jiangxi, China.
FAU - Li, Ping
AU  - Li P
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, Jiangxi, China.
FAU - Cheng, Xiao-Shu
AU  - Cheng XS
AD  - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, Jiangxi, China. Electronic address: xiaoshumenfan@126.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180403
PL  - United States
TA  - J Am Soc Hypertens
JT  - Journal of the American Society of Hypertension : JASH
JID - 101312518
OTO - NOTNLM
OT  - Homocysteine
OT  - hypertension
OT  - ischemic stroke
OT  - neurological severity
EDAT- 2018/04/22 06:00
MHDA- 2018/04/22 06:01
CRDT- 2018/04/22 06:00
PHST- 2017/12/24 00:00 [received]
PHST- 2018/03/20 00:00 [revised]
PHST- 2018/03/27 00:00 [accepted]
PHST- 2018/04/22 06:00 [pubmed]
PHST- 2018/04/22 06:01 [medline]
PHST- 2018/04/22 06:00 [entrez]
AID - S1933-1711(18)30088-3 [pii]
AID - 10.1016/j.jash.2018.03.011 [doi]
PST - ppublish
SO  - J Am Soc Hypertens. 2018 Jul;12(7):534-541. doi: 10.1016/j.jash.2018.03.011. Epub 
      2018 Apr 3.