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New Evidence For Homocysteine Lowering For Management Of Treatment-Resistant Hypertension, Merrill F. Elias, Craig J. Brown

Maine-Syracuse Longitudinal Papers

Treatment-resistant hypertension is a topic of great importance and the subject of editorial comments in the American Journal of Hypertension. Homocysteine is an intermediate compound in the vitamin regulated One Carbon Methylation pathway which affects glutathione, methionine, and nitric oxide metabolism. Elevated homocysteine, triggered by genetic mutations or insufficient body stores of active vitamins B6, B12, folate, riboflavin, indicates oxidative stress and is associated with impaired nitric oxide synthesis causing small vessel vasoconstriction in the central nervous system. High homocysteine (defined later) is also a risk factor for hypertension.