Abstract: Objective To explore the correlation of serum homocysteine（Hcy）levels and hypertrophy of left ventricle in very elderly hypertensive patients．Methods According to plasma Hcy levels，patients with essential hypertension (n= 378) were divided into non H-type hypertension group (n=142) and H-type hypertension group (n=236). Height, weight, reg⁃ ular medication, blood pressure, renal function, blood lipid profile and the concentration of plasma Hcy were recorded. Color Doppler ultrasonic equipment was used to determine the morphology and structure of left ventricle. The correlation between plasma Hcy and left ventricle remodeling was analyzed. Results The ratio of left ventricular hypertrophy was higher in Htype hypertension group than that in non H-type hypertension group（45.8% vs 24.6%，χ2=16.81，P < 0.001）. Patients in Htype hypertension group had higher systolic blood pressure, higher plasma level of Hcy and larger left ventricular posterior wall thickness（LVPWT), larger interventricular septal thickness (IVST) and increased left ventricular mass index (LVMI) compared to those in non H-type hypertension group（162.20±14.97）vs（149.70±5.06）mmHg，（19.76±5.83）μmol/L vs （9.53±0.72）μmol/L，（9.77±2.35）vs（9.21±2.68）mm,（9.74±3.15）vs（8.51±2.42）mm,（118.64±39.38）vs（101.85±41.71）g/m2 respectively, all P＜0.05）. There was a positive correlation between LVMI and Hcy（r=0.381，P < 0.001）. Multivariable Lo⁃ gistic regression analysis showed that hyperhomocysteinemia was an independent risk factor of LVMI. Conclusion High plasma Hcy level is an independent risk factor of LVMI, which works together with hypertension to promote left ventricular re⁃ molding.

Key words: hypertension, hyperhomocysteinemia, ventricular remodeling, aged, hypertrophy, left ventricular