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[Hyperhomocysteinemia. A new coronary risk factor]
R Zacarías-Castillo1, A E Hernández-Rebollar, A Zajarias-Rabchinskey
1Departamento de Medicina Interna, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, CP 14000, México, DF. rzac99@hotmail.com
Insights
High homocysteine levels contribute to atherosclerosis, a major cause of death. Folic acid and B vitamins can lower homocysteine, aiding in preventing and treating vascular disease.
Area of Science:
- Cardiovascular Medicine
- Nutritional Biochemistry
Context:
- Cardiovascular disease is the primary cause of mortality in Mexico and Western nations.
- Traditional atherosclerosis risk factors inadequately explain its prevalence.
- Hyperhomocysteinemia is an emerging risk factor for atherosclerosis.
Purpose:
- To explore the role of hyperhomocysteinemia in atherosclerosis.
- To investigate the impact of homocysteine on vascular health.
- To assess the potential of nutrient supplements in managing homocysteine levels.
Summary:
- Elevated homocysteine, an amino acid from protein metabolism, promotes endothelial damage and oxidative stress, contributing to atherosclerosis.
- Plasma homocysteine levels above 15 mmol/L, or lower with other risk factors, accelerate atherosclerotic development.
- Folic acid and vitamins B6 and B12 effectively reduce homocysteine levels.
Impact:
- Hyperhomocysteinemia is a significant, underrecognized contributor to atherosclerotic vascular disease.
- Nutritional interventions targeting homocysteine may offer a novel strategy for cardiovascular disease prevention and treatment.
Abstract:
Cardiovascular disease is the leading cause of mortality in Mexico, as well as in other Western countries. Conventional risk factors for atherosclerosis, such as cigarette smoking, systemic hypertension, diabetes mellitus, and hypercholesterolemia, do not explain this association completely. Recently, it has been recognized that hyperhomocysteinemia contributes to the atherosclerotic process, promoting endothelial damage and oxidative stress in the vascular wall. Homocysteine, an amino acid generated under physiologic conditions after ingestion of protein-rich foods, is used in a variety of metabolic pathways. Elevated plasma levels of this amino acid (higher than 15 mmol/L or lower in the presence of other cardiovascular risk factors) promote the development of atherosclerosis. Folic acid and vitamin B6 and B12 supplements decrease plasma levels of homocysteine effectively and may play an important role in the prevention and treatment of atherosclerotic vascular disease.