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Recent data are not in conflict with homocysteine as a cardiovascular risk factor
1Department of Pharmacology, University of Bergen, Norway. helga.refsum@farm.uib.no
Insights
High plasma total homocysteine is a significant risk factor for cardiovascular disease, especially in high-risk groups. Its association with cardiovascular risk is weaker in healthy individuals, suggesting it exacerbates underlying predispositions.
Area of Science:
- Cardiovascular Science
- Genetics
- Biochemistry
Background:
- Elevated plasma total homocysteine is a recognized risk factor for cardiovascular disease (CVD).
- It interacts significantly with established CVD risk factors.
- The MTHFR gene polymorphism is a key determinant of homocysteine levels but shows weak links to CVD risk.
Purpose of the Study:
- To examine the role of plasma total homocysteine as a cardiovascular disease risk factor.
- To investigate the relationship between homocysteine levels, MTHFR gene polymorphism, and cardiovascular outcomes.
Main Methods:
- Analysis of plasma total homocysteine levels.
- Assessment of MTHFR gene polymorphism.
- Correlation with cardiovascular disease events and risk factors.
Main Results:
- Elevated homocysteine is an independent, graded risk factor for CVD, particularly in high-risk populations.
- The association is weaker in healthy individuals.
- MTHFR polymorphism influences homocysteine levels but is generally not directly linked to CVD risk.
Conclusions:
- High homocysteine may not be directly harmful but can provoke vascular events in susceptible individuals.
- Understanding homocysteine's role in conjunction with other risk factors is crucial for CVD prevention.
Abstract:
An elevated level of plasma total homocysteine is an independent, graded and strong risk factor for cardiovascular disease, which shows a strong interactive effect with conventional risk factors. It is a predictor of cardiovascular disease events in high-risk populations, but is weakly associated with risk in healthy individuals. A common polymorphism in the MTHFR gene is a major determinant of the total homocysteine level, but is unrelated to cardiovascular disease risk in most studies. This observation is in accordance with the view that high total homocysteine itself may not be particularly deleterious, but provokes vascular occlusion under conditions predisposing to cardiovascular disease.