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Homocysteine, menopause and cardiovascular disease

Marco Gambacciani1, Paolo Mannella

  • 1Department of Reproductive Medicine and Child Development, Division of Obstetrics and Gynaecology, University of Pisa, Via Roma 57, 56100 Pisa, Italy. margamba@tin.it

Menopause International
|April 24, 2007
PubMed

Insights

High homocysteine levels and vitamin deficiencies are linked to cardiovascular disease. Hormone replacement therapy may lower homocysteine in postmenopausal women, but its cardiovascular benefits require further research.

Area of Science:

  • Biochemistry
  • Cardiovascular Medicine
  • Endocrinology

Background:

  • Elevated plasma total homocysteine (tHcy) and deficiencies in B vitamins (folate, B12) are associated with cardiovascular disease (CVD).
  • Postmenopausal women exhibit higher tHcy concentrations compared to premenopausal women.
  • Hormone replacement therapy (HRT) is associated with lower plasma tHcy in postmenopausal women.

Purpose of the Study:

  • To examine the relationship between homocysteine, vitamin status, and cardiovascular disease.
  • To investigate the effect of hormone replacement therapy on homocysteine levels in postmenopausal women.

Main Methods:

  • Plasma total homocysteine (tHcy) levels were measured.
  • Vitamin B12 and folate status were assessed.
  • Hormone replacement therapy (HRT) use was considered in postmenopausal women.

Main Results:

  • High plasma tHcy and vitamin deficiencies are linked to cardiovascular disease.
  • Postmenopausal women on HRT showed significantly lower plasma homocysteine concentrations compared to non-users.
  • The cardiovascular implications of HRT require cautious interpretation due to potential mixed effects.

Conclusions:

  • While homocysteine measurement is feasible, population screening requires robust trial evidence.
  • The benefits of reducing homocysteine via folic acid, vitamin B6, and B12 supplementation remain debated.
  • Further research is needed to clarify the role of homocysteine and HRT in cardiovascular health.

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