Related Experiment Videos
Homocysteine and atherosclerosis
1Department of Medicine, Oregon Health Sciences University, Portland 97201-3098, USA. gerhardg@ohsu.edu
Insights
Elevated total homocysteine is a significant risk factor for atherosclerotic vascular disease. Lowering homocysteine levels, primarily with folic acid, may reduce cardiovascular risk, though further trials are needed.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Public Health
Background:
- Elevated plasma total homocysteine is a recognized independent risk factor for atherosclerotic vascular disease.
- Cardiovascular risk increases with rising homocysteine concentrations, becoming significant above 10 mumol/l.
Purpose of the Study:
- To review the role of homocysteine in atherosclerotic vascular disease.
- To discuss screening and treatment strategies for elevated homocysteine.
- To highlight the need for further research on homocysteine-lowering therapies.
Main Methods:
- Literature review of studies on homocysteine and cardiovascular disease.
- Analysis of homocysteine levels and associated risks.
- Evaluation of current and potential treatment options, including folic acid, vitamin B12, and vitamin B6.
Main Results:
- Homocysteine levels greater than 10 mumol/l are associated with increased atherosclerotic risk.
- Screening individuals with existing or high risk of atherosclerotic disease is recommended.
- Folic acid is the primary treatment, with potential benefits from B12 and B6 in specific cases.
Conclusions:
- Lowering plasma total homocysteine to below 10 mumol/l is a potential therapeutic goal.
- Ongoing randomized trials are crucial to confirm whether homocysteine reduction translates to decreased cardiovascular disease risk.
Abstract:
Elevated plasma total homocysteine is an independent risk factor for atherosclerotic vascular disease. Risk rises continuously across the spectrum of homocysteine concentrations and may become appreciable at levels greater than 10 mumol/l. A compelling case can be made for screening all individuals with atherosclerotic disease or at high risk. A reasonable, but unproven, goal for treatment is a plasma total homocysteine concentration less than 10 mumol/l. Folic acid is the mainstay of treatment, but vitamins B12 and B6 may have added benefit in selected patients. The results of ongoing randomized placebo-controlled trials will not be available for several years, but will help determine whether homocysteine lowering reduces the risk of cardiovascular disease.