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Homocysteine and cardiovascular disease
S L Abby1, I M Harris, K M Harris
1Deaconess Family Medicine Residency Program, St. Louis College of Pharmacy, MO, USA.
The Journal of the American Board of Family Practice
|October 31, 1998
Summary
Hyperhomocysteinemia is a risk factor for coronary heart disease (CHD). Folic acid may lower homocysteine levels, but more research is needed to confirm its benefits for preventing CHD events.
Area of Science:
- Cardiovascular Medicine
- Nutritional Science
- Public Health
Background:
- Hyperhomocysteinemia is recognized as an independent risk factor for coronary heart disease (CHD).
- Folic acid is known to reduce homocysteine concentrations.
- CHD is a complex condition influenced by multiple risk factors.
Purpose of the Study:
- To review the current literature on hyperhomocysteinemia, folic acid, and coronary heart disease.
- To identify unanswered questions regarding folic acid supplementation for managing hyperhomocysteinemia and its impact on CHD.
- To assess the potential benefits and risks of folic acid supplementation in the context of CHD prevention.
Main Methods:
- Literature review of available studies on hyperhomocysteinemia and folic acid.
- Analysis of the relationship between homocysteine levels, folic acid supplementation, and cardiovascular outcomes.
- Evaluation of current recommendations and future research needs.
Main Results:
- The precise homocysteine concentration linked to increased cardiovascular risk and the required reduction for event prevention remain uncertain.
- The populations most likely to benefit from homocysteine level evaluation are not yet clearly defined.
- While clinical outcome data from randomized trials are pending, the potential benefits of folic acid supplementation appear to outweigh the risks.
Conclusions:
- A diet rich in folic acid is recommended for everyone.
- Current FDA fortification may be insufficient for significant homocysteine reduction.
- Daily multivitamins with 400 mcg of folic acid are suggested for individuals with CHD, cardiovascular risk factors, and women of childbearing potential to potentially prevent CHD development and progression.
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