Effects of Hcy levels,MTHFR C677T genotype,and folic acid supplementa-tion on antihypertensive efficacy and target organ damage in elderly hyper-tensive patients
Objective To explore the effects of homocysteine(Hcy)levels,MTHFR C677T genotype,and folic acid supplementation on antihypertensive efficacy and target organ damage in elderly hypertensive patients.Methods A total of 190 patients with primary H-type hyper-tension diagnosed at our hospital from January 2019 to December 2022 were selected and ran-domly divided into two groups(95 cases in each group):the control group was treated with en-alapril and conventional antihypertensive drugs,and the observation group was treated with en-alapril folate tablets and conventional antihypertensive drugs.The folate levels of two groups of patients before and after treatment,carotid artery plaque score and instability rate,left ventric-ular posterior wall and interventricular septal thickness,creatinine clearance rate and 24 h u-rine microalbumin were detected,and the effects of different genotypes on folic acid interven-tion was compared.Results The observation group had better antihypertensive effect and pro-tective effect on target organs than the control group,with more stable blood pressure control,less thickening of left ventricular posterior wall and interventricular septum thickness,reduced carotid plaque integral and instability rate,higher creatinine clearance rate,lower 24 h urine microalbumin,and significantly reduced Hcy level,and significantly increased folate level.The above differences were statistically significant(P＜0.05);After folic acid treatment,pa-tients with different genotypes of hypertension showed an increase in creatinine clearance and a decrease in 24 h urinary microalbumin.Moreover,folic acid intervention significantly reduced Hcy and blood pressure levels.TT type folic acid intervention had better effects in reducing Hcy levels and blood pressure reduction.Conclusion In antihypertensive treatment,enalapril fo-late tablets combined with conventional antihypertensive drugs can better reduce Hcy levels and improve target organ damage.TT genotype has a better effect on folate intervention,and its im-pact on blood pressure levels is also more significant.
elderly hypertensionHcy levelMTHFR C677T genotypefolic acidhypoten-sion effecttarget organ damage
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