Homocysteine and Initial Stage of Cardiovascular Disease (Brief Review of Etiopathogenetic Findings)

Overview

New findings on pathogenetic mechanisms of atherosclerosis and cardiovascular disease (CVD) led to revision of hitherto held views of their initial stage. According to the hypothesis of „programming chronic diseases in utero“ it is apparent that the etiopathogenesis of both diseases is a complicated mosaic of genetic and environmental influences which play a part already in early developmental stages. An important part in the cascade of pathological processes is held by metabolic deviations, in particular abnormalities of the insulin and lipid metabolism, and according to recent findings also of homocysteine (Hcy). The impaired balance of formation and further metabolism of Hcy leads to hyperhomocysteinaemia (HHcy) which has an adverse impact on different components of the vascular wall by toxic effects, changes of vasoactivity, enhancement of procoagulation mechanisms and oxidative stress. The authors discusse in the submitted paper the mechanism of development, action of HHcy, possible prevention and treatment and the relationship of HHcy and hypertension. The paper is the introduction to publication of the results of the author’s own work which was part of an IGA grant project 4698-3 focused on selected signs of the phenotype and genotype of juvenile hypertension.

Key words:
atherosclerosis, homocysteine, cardiovascular disease, primary hypertension