Dr Sudhir Kumar MD DM
Dr Sudhir Kumar MD DM

@hyderabaddoctor

9 Tweets 23 reads Dec 18, 2022
Elevated #Homocysteine levels increase the risk of #stroke
1. Homocysteine (Hcy) is a sulfur-containing amino acid produced by the demethylation of the essential amino acid methionine, and the normal level is 5-15 µmol/L. High Hcy levels can increase the risk of stroke.
2. Total Hcy elevations above 15 µmol/L are an independent risk factor for ischemic stroke.
The risk of stroke is two times higher in people with Hcy >15 µmol/L as compared to those with Hcy level <10 µmol/L.
#MedTwitter #NeuroTwitter
3. The risk of #death is 43% higher in patients with ischemic stroke, who have elevated Hcy levels.
Hcy is not only a risk factor for, but is also correlated with, stroke severity, worse #prognosis, and stroke recurrence.
4. High Hcy levels caused by metabolic disorders of Hcy are an independent risk factor for #hypertension, myocardial infarction, peripheral arterial occlusive disease, venous thrombosis, hemorrhagic strokes, and myocardial infarction.
5. Male gender, #smoking and #vitamin B12 deficiency are associated with elevated levels of homocysteine in blood.
6. Studies on high Hcy levels as cause of ischemic stroke have found that Hcy damages endothelial cells, increases vascular smooth muscle, inflammatory process, oxidative insult & enhances production of fibrinogen leading to abnormal coagulation together with platelet dysfunction
7. Supplementation with folic acid, vitamin B6 and B12 can lower elevated homocysteine levels.
8. Take home message:
*Elevated Hcy level >15 µmol/L is an important risk factor for stroke in young.
*In addition to screening for traditional risk factors (such as high BP, sugar and cholesterol), we should screen for homocysteine levels too.

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