The dangers of high blood pressure
According to the "2020 China Cardiovascular Health and Disease Report", the number of cardiovascular diseases in China has reached 330 million, of which stroke is 0.13 billion and hypertension is 245 million, and the prevalence of cardiovascular disease in China is in a continuous upward trend, seriously threatening the life and health of the people.
In addition to the traditional blood pressure, blood sugar, blood lipids, homocysteine (homocysteine, Hcy) detection has gradually become a compulsory inpatient examination item in many domestic hospitals, and has also become a routine physical examination item for people over 40 years old.
Hcy is a risk factor for a variety of diseases, which can increase the risk of cardiovascular and cerebrovascular diseases, such as coronary atherosclerosis, hypertension, diabetes, coronary heart disease, stroke, etc., and can also cause kidney disease, liver disease, cognitive impairment, senile dementia, preeclampsia, neural tube malformations and so on.
At present, the mortality rate of cardiovascular disease in mainland China ranks first among all etiological causes, of which hypertension is the primary factor leading to the incidence and death of cardiovascular disease.
Source: 2020 China Cardiovascular Health and Disease Report
H-type hypertension
Hypertension is accompanied by hyperhymicemia, i.e. H hypertension.
Hcy is a sulfur-containing amino acid produced in the process of methionine metabolism, when the body has dysfunction and Hcy cannot be metabolized smoothly, it will accumulate more and more in the body, forming hyperhyemia.
Hyperhyemia is an important risk factor for atherosclerosis, which can damage the endothelial cells of blood vessels, promote oxidative stress response, easily form atherosclerotic plaques, and cause narrowing of blood vessels.
Lesions of the arteries also produce changes in blood pressure, so it also has an effect on high blood pressure. Hypertension is accompanied by hyperhyemia, known as H-type hypertension. If the ≥ 10 μmol/L of Hcy is defined as hyperhyemia[1], up to 75% of patients with hypertension in mainland China have high Hcy [2]. Among patients with hypertension in China, the proportion of high-Hcy patients is 80.3%[3].
Other studies have shown that when high Hcy and hypertension are present at the same time, the risk of cardiovascular and cerebrovascular disease is higher than that of the two unidentifers [4]. Nearly 180 million people aged ≥ 40 years old on the mainland have hyperhymicemia, and if the residents have hypertension and hyperhyemia, their risk of stroke is significantly increased by 75.2%.
Serum homocysteine levels gradually increase with age, serum homocysteine levels are higher in men than in women, serum homocysteine levels in smoking, hypertension, and diabetes are significantly elevated, and the more fruits and vegetables are consumed, the higher the level of physical activity, and the lower the serum homocysteine level [5].
H-type hypertension is detected early and treated early
H-type hypertension is a great harm to cardiovascular and cerebrovascular diseases, and requires early detection and early prevention. It is recommended that clinicians can routinely test Hcy in patients with hypertension, and once they find that Hy ≥ 10umol/L hypertension patients, they can enter the scope of prevention and treatment of H-type hypertension, and regularly monitor blood pressure and Hcy value.
The Chinese Guidelines for the Prevention and Treatment of Hypertension 2010 and the Expert Consensus on the Diagnosis and Treatment of H Hypertension 2016 define H hypertension as hypertension with elevated Hcy (≥ 10 μmol/L) and recommend that all patients with hypertension should have blood Hcy tested.
The "Expert Consensus on the Diagnosis and Treatment of H-type Hypertension 2016" also pointed out that the proportion of outpatient hypertension patients in mainland China who screened blood Hcy was low, and in addition, hypertensive patients should be screened for Hcy, and patients with high Hcy levels should be treated accordingly.
Patients with H-type hypertension need to manage hypertension and hcy elevated blood at the same time. In addition to looking for causative factors of high blood pressure and lowering blood pressure, dietary adjustments such as eating more fresh fruits and vegetables, animal offal, egg yolks and low-fat dairy products are also needed to reduce the intake of fatty animal meat. If necessary, under the guidance of a doctor, take folic acid, vitamin B6, vitamin B12, etc. to reduce blood Hcy, while quitting smoking and limiting alcohol, going to bed early and getting up early, and exercising appropriately to enhance physical fitness.
Source: Expert Consensus on the Diagnosis and Treatment of Type H Hypertension 2016
Detection advantages of small chemiluminescence
Based on Hcy's test results, hyperhyemia can be classified into three grades: mild, moderate, and severe, so the accurate quantification of Hcy's results is crucial.
Traditional Hkey biochemical analysis methods generally have problems such as poor specificity and related cross-reaction interference, which are difficult to achieve accurate quantification, and take time, cumbersome operation (latex enhanced immunoturbidity technology), and limited detection range (enzyme circulation technology).
Chemiluminescence technology has become the "gold standard" of current immunoassays with high sensitivity, wide detection range and good repeatability, and also has the advantages of high automation procedures, fast detection speed and stable reagent quality. Especially in recent years, with the continuous upgrading of chemiluminescence technology, fully automatic small luminescence stands out.
Compared with the original large luminescence, the automatic small luminescence is getting smaller and smaller, and the weight is getting lighter and lighter, and it has been given more roles in sharing the pressure of outpatient treatment in large and medium-sized hospitals in large and medium-sized cities in the perspective of common diseases, multiple diseases and chronic diseases in the majority of primary medical institutions in China. It plays an important role in integrating domestic medical resources, improving the efficiency of physician diagnosis and treatment and improving the patient experience.
Advantages of the Tianchen homocysteine project
Tianchen CL-2000 application advantages
Fast: fast, the first result is 10min, 120T/h, improve the work efficiency of medical staff;
Accurate: accurate results, magnetic particle enzymatic chemiluminescence method, assist clinicians in diagnosis and treatment more accurately;
Small: small size, <0.2m3, small size and large capacity, emergency emergency clinical emergency;
Jane: Simple operation, fully automatic, saving the workload of medical staff.
Tianchen comprehensive advantages
Supports whole blood testing;
The repeatability and accuracy of chemiluminescence are far superior to fluorescence immunochromatography;
Multiple inspections are faster than other methodologies and much better than other methodologies;
It has the function of continuously reflecting the trend of a certain indicator of patients, which provides more reference for accompanying diagnosis and monitoring treatment.
【Reference】
Wei Yulu. Research progress related to hyperhomocysteinemia and cerebrovascular disease[J].Medical Theory and Practice,2019,32(7):968-969.
[2] Li Jianping,Huo Yong,Liu Ping,et al. Efficacy and safety of enalapril folic acid maleate tablets in lowering blood pressure and homocysteine[J].Journal of Peking University (Medical Edition), 2007,39(6):614-618.
[3] HUO Y,LI J P,QIN X H,et al . Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China:the CSPPT randomized clinical trial[J]. JAMA, 2015, 313(13): 1325- 1335.
Zong Yonghua, Xu Xiping, Huo Yong, et al. Legacy and environmental factors affecting the occurrence of H-type hypertension in rural Areas of Anqing[J].Chinese Journal of Hypertension,2011,19(5):445-449.
[5] Status of hyperhomocysteinemia in China: results from the China Stroke High-risk Population Screening Program, 2018[J]. 医学前沿, 2021, 15(6):903-912.
Edited by: Yeah Reviewer: Xiao Ran