Homocysteine and folate levels as indicators of cerebrovascular accident

BACKGROUND Homocysteinemia has been established as a risk factor for cardiovascular disorders by the American Heart Association.1 Cerebrovascular accident (stroke) is presently ranked as one of the leading causes of morbidity and mortality worldwide. The aim of this study was to determine homocysteine and folate levels and some basic hematologic parameters in patients who sustain a cerebrovascular accident and those who do not. METHODOLOGY In total, 100 participants were recruited, comprising 40 clinically diagnosed stroke (hemorrhagic or thromboembolic) patients and 60 healthy control subjects. Plasma homocysteine and folate levels were measured. Anticoagulated whole blood samples were evaluated for hemoglobin concentration (Hb), packed cell volume (PCV), white blood cell (WBC) count, and mean cell volume (MCV). RESULTS The mean age of stroke patients was 62 ± 12 years and that of controls was 55 ± 18 years (P = 0.1756). Mean plasma homocysteine levels for stroke patients and controls were 17.7 ± 4.4 μmol/L and 9.5 ± 2.4 μmol/L, respectively (P = 0.0000) and mean plasma folate levels for the groups were 6.5 ± 2.9 μg/dL and 4.0 ± 2.4 μg/dL (P = 0.0407). The MCV for stroke patients was significantly higher than that for controls (85 fl versus 82 fl, P = 0.04). Mean homocysteine levels correlated inversely with Hb and PCV (r = -0.08 and r = -0.122, respectively) and weakly with WBC (P = 0.125). CONCLUSION Homocysteinemia is a major predictor of cerebrovascular accident in the black Nigerian population.