[Hyperhomocysteinemia: a new independent vascular risk factor?]

The positive correlation existing between hyperhomocysteinemia and atherosclerosis has firmly been established through data derived from numerous epidemiologic and experimental observations as well as from intervention trials. Although most of the clinical data have been obtained in relation to coronary heart disease, hyperhomocysteinemia is also observed in patients with cerebral and peripheral arterial occlusive disease or peripheral venous thrombosis. The prevalence of the heterozygous state is today estimated about 1 to 2 percent of the population. Mild and moderate hyperhomocysteinemia have recently been proposed as an additional and independent risk factor for vascular disease. In this review we therefore describe recent findings about the pathogenesis of hyperhomocysteinemia and their implications for optimal drug therapy.