Homocysteine and masked hypertension

To the Editor,

The recent report “Homocysteine and masked hypertension” in Anatolian J Cardiol 2014; 14: 357-62 is very interesting (1). They noted that “in the individuals with no obvious health problems but with MHT, homocysteine levels may not have any significant effect upon high blood pressure levels (1).” In fact, several factors are accepted as contributing factors for “masked hypertension,” including “younger age, smoking, alcohol use, contraceptive use in women, sedentary habits, and central obesity (2)”. The negative finding on the role of homocysteine level in the present report should be discussed. In fact, homocysteine has been accepted as a good biomarker for identifying risk of cardiovascular disease for a long time (3). However, in addition to hypertension, other vascular pathologies are related to the change of blood homocysteine level. This fact has to be considered in the interpretation of the homocysteine level results. Another important consideration in the determination of homocysteine levels is the false positivity (4). Pre-analytical errors in specimen collection and preparation can significantly result in elevated blood homocysteine levels (4).

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