Homocysteine and Folic Acid Are Inversely Related in Black Women With Preeclampsia

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2004-06, Vol.43 (6), p.1279-1282
• Main Authors: Patrick, Thelma E, Powers, Robert W, Daftary, Ashi R, Ness, Roberta B, Roberts, James M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Arterial hypertension. Arterial hypotension; Arteriosclerosis - ethnology; Biological and medical sciences; Black or African American; Black People; Blood and lymphatic vessels; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Female; Folic Acid - blood; Homocysteine - blood; Hormones. Endocrine system; Humans; Hyperhomocysteinemia - blood; Hyperhomocysteinemia - ethnology; Maternal Age; Medical sciences; Pennsylvania - epidemiology; Pharmacology. Drug treatments; Pre-Eclampsia - blood; Pregnancy; Pregnancy Complications - blood; Pregnancy Complications - ethnology; Risk Factors; Vitamin B 12 - blood; White People
• ISSN: 0194-911X; 1524-4563; 1524-4563
• DOI: 10.1161/01.HYP.0000126580.81230.da

Black women have an increased risk of preeclampsia compared with white women. Plasma homocysteine is increased in preeclampsia. Homocysteine concentrations are affected by nutritional deficiencies, particularly decreased folic acid and B12, leading to increased homocysteine. Previous studies have reported racial differences in nutritional intake including folic acid. Therefore, we investigated whether there were racial differences in plasma homocysteine, folic acid, and vitamin B12 among women with preeclampsia. We tested for an association between homocysteine and folic acid and B12, and we hypothesized an inverse relationship of homocysteine and folic acid in preeclampsia, more so in black women in whom preeclampsia developed. Black women with preeclampsia (n= 26) had elevated homocysteine concentrations (8.7±1.4 μmol/L) compared with black women with normal pregnancy (n= 52, 7.6±0.5 μmol/L), white women with preeclampsia (n= 34, 7.5±0.6 μmol/L), and white women with normal pregnancy (n= 48, 5.5±0.3 μmol/L). Folic acid concentrations were lower in black women (14.1±0.8 ng/mL) compared with white women (18.5±0.9 ng/mL, P < 0.01). However, plasma homocysteine was inversely related to folic acid only among black women with preeclampsia (r = −0.23, P = 0.01). These racial differences may have implications for the higher rates of preeclampsia in this group and may have long-term implications for future cardiovascular risk. Racial differences in diet, adherence to folic acid supplementation, or interactions of nutritional and maternal factors warrant further study by race and pregnancy status.