It is necessary for friends with hypertension to have regular medical checkups to understand their health status, to know which indicators are abnormal at an early stage, and to make timely lifestyle adjustments or medication to improve or reverse the abnormalities in their bodies as soon as possible. Routine checkups for blood lipids, blood sugar, uric acid, and blood viscosity have attracted a lot of attention. In recent years, risk factors related to hypertension are gradually being discovered, and homocysteine is one of them, but people don’t pay much attention to it yet or don’t know enough about it, and some places don’t routinely carry out this program yet. Elevated homocysteine can cause a special type of hypertension called “H-type hypertension”, and scientific research has confirmed that stroke is closely related to H-type hypertension, which is one of the culprits of stroke in hypertensive patients and is a risk factor that can be prevented at an early stage. Therefore, knowing about homocysteine and determining whether you have H-type hypertension is an important target for preventing and reducing the harm of hypertension and preventing stroke. So what is the relationship between elevated homocysteine and cerebral atherosclerosis and stroke? Homocysteine is a variant species of our essential amino acid, a sulfur-containing amino acid, mainly derived from methionine in food, an important intermediate product in the metabolism of methionine and cysteine, which itself is not involved in protein metabolism. Lack of folic acid, vitamin B6, and vitamin B12 can affect the metabolism of cysteine and make homocysteine elevated. The history goes back to 1969, when scientists found that children with hereditary homocysteinemia developed systemic atherosclerosis very early and were prone to arterial thrombosis, a phenomenon that could not occur in normal children. Because homocysteine affects the normal metabolism and function of cysteine and lysine, the structure of homocysteine is mutated, and the structural proteins involved in the composition of arteries, such as collagen, elastin and polysaccharide proteins, cannot be formed, affecting their growth and premature aging and decline, thus causing structural disorders and fragility of blood vessels. In the 1980s, after a lot of scientific experiments and clinical observations, it was officially proposed that “homocysteinemia is an independent risk factor for atherosclerosis and coronary heart disease”. As we all know, China is a country with a high incidence of stroke and a very high disability rate. According to statistics, 75% of hypertensive patients in China have elevated homocysteine levels, and some of them develop into H-type hypertension, which becomes difficult to treat and prone to complications. The incidence of hypertension in the southern region is lower than that in the north, and the level of homocysteine is also lower than that in the north; moreover, homocysteinemia has a familial genetic tendency, which is due to genetic mutations of enzymes related to homocysteine metabolism, and the genes present polymorphisms. Cerebrovascular accidents occur, and the incidence of stroke is significantly higher than that of hypertensive friends with normal homocysteinemia. Recent clinical studies have shown a quantitative relationship between elevated homocysteinemia levels and cardiovascular risk, i.e., the greater the elevation, the higher the cardiovascular risk, and studies have measured that for every 5 umol/L increase in homocysteine levels, the risk of stroke increases by 59%, and for every 3 umol/L decrease in homocysteine levels, the risk of stroke decreases by 24%. In recent years, the results of epidemiological surveys conducted in China and the United States have also shown that the proportion of hypertensive patients with high levels of homocysteinemia is higher in China than in the United States, while the level of obesity and hyperlipidemia in Americans is much greater than that in the Chinese, and the incidence of stroke is not high. It is therefore likely that hyperhomocysteinemia is an important factor in the susceptibility of the Chinese to stroke. What are the factors that interfere with the determination of homocysteine? In the past, amino acid analyzers were used to determine homocysteine, which was complicated and unstable, and was difficult to carry out routinely in clinical practice. The normal reference value of homocysteine varies with the measurement method and ethnic group, and the normal fasting plasma homocysteine level is 5-15umol/L. Influencing factors 1. Gender and age: Studies have found that homocysteine is lower in women than in men, and homocysteine levels are lower in premenopausal women than in postmenopausal women, and the older the age, the higher the homocysteine level. 2, diet and drugs: High protein diet with high content of methionine, excessive intake is easy to cause homocysteine level to rise; vegetables and fruits help to reduce homocysteine level due to high content of folic acid and vitamin B, especially fresh vegetables, but over-steamed and boiled vegetables have weakened effect due to vitamin and more destruction of folic acid. Antitumor drugs such as methotrexate can cause elevated homocysteine due to inhibition of folic acid metabolism, long-term oral contraceptives, anti-tuberculosis can lead to vitamin B6 deficiency and reduced conversion of homocysteine, which increases its level. 3. Certain diseases, such as chronic liver disease, hypothyroidism and tumors, can cause a mild to moderate increase in homocysteine levels; chronic renal insufficiency can also increase homocysteine, and the more severe the renal impairment, the higher the homocysteine level. In conclusion, homocysteine level is closely related to hypertension and stroke, so it is important to detect homocysteine and keep it within the normal range, which can effectively reduce the occurrence of “stroke”.