High Homocysteine Associated with Cardiovascular Diseases

Abstract

Vascular disease is one of the abnormalities in the hereditary condition homocystinuria. In 1969 and in 1976 it was suggested that only moderately raised plasma homocysteine, from any cause might be associated with coronary and other vascular disease. In the 1990s many epidemiological studies reported on this association, at first case-control studies, later prospective studies. The great majority found increased serum homocysteine was associated with CHD, cerebral or peripheral vascular disease. Although homocysteine is a normal metabolite, higher concentrations appear to damage endothelium. Vitamin B-6, folic acid and B-12 are all involved in pathways that metabolise homocysteine. Trials showed that moderate dose supplements of folic acid with or without vitamin B-12 lowered plasma homocysteine. Results of randomised controlled prevention trials, with disease outcome would be reported after 2000. Years 1976–1999.