Hyperhomocysteinaemia and atherothrombosis

Area of Science:

• Cardiovascular Science
• Metabolic Disorders
• Vascular Biology

Background:

• Homocysteine (Hcy), a methionine metabolite, requires B vitamins (folic acid, B12, B6) as cofactors.
• Hyperhomocysteinaemia has been linked to atherosclerosis and occlusive arterial disease since 1969.
• Emerging evidence suggests hyperhomocysteinaemia also contributes to venous thromboembolism.

Purpose of the Study:

• To review the association between hyperhomocysteinaemia and vascular diseases.
• To discuss the potential mechanisms linking Hcy to atherogenesis and thrombogenesis.
• To evaluate the efficacy of vitamin supplementation in reducing vascular risk.

Main Methods:

• Review of case-control, cross-sectional, and prospective cohort studies.
• Analysis of findings from studies on healthy subjects and those with existing cardiovascular disease.
• Consideration of ongoing randomized, placebo-controlled, double-blinded trials.

Main Results:

• Consistent evidence links moderate hyperhomocysteinaemia to cardiovascular morbidity and mortality.
• Association between hyperhomocysteinaemia and venous thromboembolism risk is increasingly recognized.
• Vitamin supplementation effectively reduces plasma Hcy levels.

Conclusions:

• Hyperhomocysteinaemia is a significant risk factor for both arterial and venous vascular diseases.
• The causal role of hyperhomocysteinaemia in vascular disease and the benefit of vitamin therapy remain under investigation.
• Results from ongoing trials are crucial for determining the impact of vitamins on preventing thromboembolic events.