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Homocysteine as a risk factor for cardiovascular disease: should we (still) worry about?

David Faeh1, Arnaud Chiolero, Fred Paccaud

  • 1University Institute for Social and Preventive Medicine, Lausanne, Switzerland. David.Faeh@unil.ch

Swiss Medical Weekly
|January 17, 2007
PubMed

Insights

Elevated homocysteine levels are not proven to increase cardiovascular disease (CVD) risk. Current evidence does not support screening or treating hyperhomocysteinaemia to reduce CVD incidence.

Area of Science:

  • Cardiology
  • Biochemistry
  • Public Health

Background:

  • Cardiovascular disease (CVD) is a primary global cause of mortality.
  • Classical risk factors for CVD include hypertension, dyslipidemia, hyperglycemia, and smoking.
  • Elevated plasma homocysteine is a potential, though debated, CVD risk factor.

Purpose of the Study:

  • To evaluate the association between elevated homocysteine levels and cardiovascular disease risk.
  • To assess the efficacy of lowering homocysteine concentrations in preventing CVD events.

Main Methods:

  • Review of population-based studies examining homocysteine and CVD risk.
  • Analysis of randomized clinical trials assessing homocysteine-lowering interventions.

Main Results:

  • Population studies show limited association between moderate hyperhomocysteinaemia and CVD risk.
  • Randomized trials have not conclusively demonstrated that lowering homocysteine reduces CVD incidence.

Conclusions:

  • Screening and treating asymptomatic hyperhomocysteinaemia is currently not recommended.
  • Focusing on established CVD risk factors remains the priority for cardiovascular health.

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