Homocysteine and atherothrombosis: diagnosis and treatment

Area of Science:

• Cardiovascular Science
• Nutritional Biochemistry
• Public Health

Background:

• Hyperhomocysteinemia is a known risk factor for cardiovascular disease (CVD).
• Observational studies link elevated total homocysteine (tHcy) to coronary, peripheral, and cerebral vascular diseases.
• Prospective study results on the association between homocysteine and CVD risk have been inconsistent.

Purpose of the Study:

• To evaluate the association between homocysteine levels and cardiovascular disease risk.
• To assess the impact of folate supplementation on plasma homocysteine and endothelial function.
• To review current evidence on homocysteine reduction and cardiovascular outcomes.

Main Methods:

• Review of cross-sectional, retrospective case-control, and prospective studies.
• Analysis of clinical trials investigating folate supplementation effects.
• Examination of studies on endothelial dysfunction and atherothrombotic risk markers.

Main Results:

• Evidence suggests a modest association between elevated homocysteine and CVD risk.
• Folate supplementation effectively reduces plasma homocysteine, even in normal ranges.
• Lowering homocysteine may improve endothelial dysfunction and reduce cardiovascular event rates.

Conclusions:

• While long-term effects require further study, evidence suggests a benefit in reducing plasma homocysteine levels.
• Individuals with lower homocysteine levels demonstrate reduced cardiovascular event rates.
• Folate supplementation represents a potential strategy for cardiovascular risk reduction.