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Homocysteine as a risk factor for atherosclerosis
M E Temple1, A B Luzier, D J Kazierad
1Infectious Disease & Pediatric Pharmacotherapy, College of Pharmacy, The Ohio State University, Columbus, USA.
The Annals of Pharmacotherapy
|February 11, 2000
Summary
Elevated homocysteine is linked to atherosclerosis. Folic acid, at 650 microg/d, effectively lowers homocysteine levels, but long-term treatment and dietary changes are crucial for managing this risk factor.
Area of Science:
- Cardiovascular Medicine
- Nutritional Science
- Biochemistry
Background:
- Homocysteine is an amino acid linked to cardiovascular disease.
- Hyperhomocysteinemia, or high homocysteine levels, is implicated in the development of atherosclerosis.
- Understanding homocysteine's role is vital for preventing cardiovascular events.
Purpose of the Study:
- To review the role of homocysteine in atherosclerosis pathogenesis.
- To provide recommendations for treating hyperhomocysteinemia.
- To synthesize current evidence on homocysteine and vascular health.
Main Methods:
- Conducted a MEDLINE search (1966-1999) for studies on homocysteine, atherosclerosis, and related vitamins.
- Included studies assessing hyperhomocysteinemia's vascular effects, physiological changes, and clinical outcomes.
- Evaluated studies examining treatment outcomes for hyperhomocysteinemia.
Main Results:
- Elevated homocysteine found in 30-40% of patients with cerebrovascular disease.
- Strong correlation observed between high homocysteine, myocardial infarction risk, and mortality.
- Folic acid (650 microg/d) normalized homocysteine in two weeks; vitamins B6 and B12 were effective only with folic acid.
- Dietary factors, like coffee consumption, correlate with hyperhomocysteinemia, while folate-rich foods may reduce it.
Conclusions:
- Hyperhomocysteinemia is positively correlated with atherosclerosis.
- Folic acid is the primary treatment for hyperhomocysteinemia, with 650 microg/d as a minimum effective dose.
- Further research is needed to assess the impact of treating hyperhomocysteinemia on atherosclerotic morbidity and mortality.