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Homocysteine: is it a clinically important cardiovascular risk factor?
Steven R Lentz1, William G Haynes
1Department of Internal Medicine, University of Iowa, Iowa City 52242, USA. steven-lentz@uiowa.edu
Cleveland Clinic Journal of Medicine
|October 14, 2004
Summary
High homocysteine levels increase risks for heart attack, stroke, and blood clots. While B vitamins lower homocysteine, clinical benefits require further study in ongoing trials.
Area of Science:
- Cardiovascular Medicine
- Nutritional Science
- Clinical Trials
Background:
- Elevated plasma homocysteine is a known risk factor for major cardiovascular events.
- Conditions linked to high homocysteine include myocardial infarction, stroke, and venous thromboembolism.
Purpose of the Study:
- To evaluate the clinical significance of lowering plasma homocysteine levels.
- To determine if homocysteine-lowering therapy provides tangible patient benefits.
Main Methods:
- Review of existing literature on homocysteine and cardiovascular risk.
- Analysis of data from ongoing clinical trials investigating homocysteine-lowering interventions.
Main Results:
- Folic acid and B vitamins effectively reduce plasma homocysteine concentrations.
- The clinical benefit of this reduction in preventing cardiovascular events remains undetermined.
Conclusions:
- Current evidence does not confirm that lowering homocysteine improves clinical outcomes.
- Testing and treatment are likely warranted only for high-risk patients or those with existing cardiovascular disease pending trial results.