Moderate hyperhomocysteinaemia and vascular disease: evidence, relevance and the effect of treatment

Abstract

Convincing evidence of moderate hyperhomocysteinaemia as a risk factor for vascular disease has accumulated within the last decade being independent of conventional risk factors and equally strong as hypercholesterolaemia and smoking. A synergistic interaction with hypertension and smoking in their joint arteriosclerotic effect in patients is demonstrated which makes the result of homocysteine-lowering intervention very promising, especially in those vascular patients with an association of these risk factors.

Conclusion Despite the proven homocysteine-lowering effect of intervention with sample, safe, and cheap vitamin regimen, no data are so far available on the clinical outcome of such treatment. Clinical trials to demonstrate a hopefully beneficial result of homocysteine reduction are urgently needed.