Association of plasma homocysteine and ischaemic stroke in a nigerian population

Epidemiologic evidence suggests that raised plasma homocysteine is an independent risk factor for ischaemic stroke. However, other studies found no association between plasma homocysteine and stroke. Our objective was to determine the relationship between plasma homocysteine concentrations and ischaemic stroke in the Nigerian population where there is no existing published data. Case-control study. University of Maiduyguri Teaching Hospital, Maidyguri, Nigeria. Fifty patients with ischaemic stroke and 50 control subjects, aged and sex-matched, were studied in relation to plasma homocysteine and other vascular risk factors. Comparison of mean plasma homocysteine between stroke cases and control subjects and Odds Ratios for stroke in patients with hyperhomocysteinemia. Mean plasma homocysteine was significantly higher in stroke cases than in control subjects [mean +/- SD: 20.8 +/- 10.2 micro mol/Lvs. 13.1 +/- 4.5 micro mol/L; P<0.001]. Other factors associated with ischaemic stroke were obesity, hypertension and elevated serum cholesterol. Using logistic regression analysis, there was an adjusted Odds Ratio of 1.9 [95% CI, 1.16-3.08] for ischaemic stroke for every 5 micro mol/L increase in plasma homocysteine concentrations. Raised plasma homocysteine was significantly associated with ischaemic stroke and treating hyperhomocysteinemia may be an effective way of decreasing the incidence of stroke

Cerebrovascular disease: antiplatelet therapy vs vascular surgery

Cerebrovascular disease is one of the leading causes of death in industrialized nations. Many clinical trials have evaluated the antiplatelet properties of aspirin in the prevention of this disease. Clear-cut answers have not been obtained in primary prevention, and even in secondary prevention, where some benefits have been demonstrated, there still remains the question of dosages. Similarly, the benefit from vascular surgery has been evaluated with disappointing results. However, it should be remembered that hypertension is one of the leading risk factors for stroke. With the present day armamentarium of antihypertensive drugs, much can be achieved in the prevention of stroke by early diagnosis and treatment while the search for the effective dose of aspirin continues. Developing countries will be well advised to take heed of this and treat hypertension early