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Homocysteine and Non-Cardiac Vascular Disease

Niki Katsiki1, Pablo Perez-Martinez2, Dimitri P Mikhailidis3

  • 1Second Propedeutic Department of Internal Medicine, Medical School, Aristotle; University of Thessaloniki, Hippocration Hospital, Thessaloniki. Greece.

Current Pharmaceutical Design
|March 21, 2017
PubMed

Insights

Elevated homocysteine (Hcy) is linked to cardiovascular disease (CVD) and mortality. While supplements lower Hcy, their impact on CVD risk is unclear, and routine screening isn't recommended.

Area of Science:

  • Biochemistry
  • Cardiology
  • Vascular Medicine

Background:

  • Elevated homocysteine (Hcy) levels are established predictors of cardiovascular disease (CVD) and mortality.
  • The precise role of Hcy, whether as a marker or a causal agent in CVD, requires further investigation.

Purpose of the Study:

  • To review the association between Hcy and non-cardiac vascular diseases.
  • To examine the impact of various drugs on Hcy levels.
  • To assess the clinical utility of Hcy screening and supplementation.

Main Methods:

  • Narrative review of existing literature.
  • Analysis of studies on Hcy and vascular diseases including stroke, PAD, CKD, and ED.
  • Evaluation of the effects of folic acid, vitamin B6, and B12 supplementation on Hcy levels.

Main Results:

  • Hyperhomocysteinemia is associated with increased risk of stroke, peripheral artery disease (PAD), chronic kidney disease (CKD), and erectile dysfunction (ED).
  • Supplementation with folic acid, vitamin B6, and B12 effectively reduces circulating Hcy concentrations.
  • The clinical benefit of Hcy-lowering therapies on CVD risk reduction remains conflicting and inconclusive.

Conclusions:

  • Current evidence does not support routine Hcy screening for patients with non-cardiac vascular diseases.
  • Further research is essential to clarify the causal role of Hcy in vascular diseases and its implications for clinical practice.
  • The conflicting results regarding supplementation efficacy necessitate more targeted studies.

Keywords:
Homocysteinecarotid artery diseasechronic kidney diseaseerectile dysfunctionperipheral artery diseasestrokevitamin B.

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