Heart
Disease
[see also Cardiovascular
Plaque, Stroke, Blood
Pressure, Memory]
HOW LOW SHOULD HOMOCYSTEINE LEVELS GO? 1
Publisher's abstract: British
Journal of Medicine. 2002;325:1202
A decrease in homocysteine of 3 mmol/L (achievable by daily intake of about 0.8 mg folate) is expected to reduce the risk of heart disease by 16%, deep vein thrombosis by 25%, and stroke by 24%.
HEART DISEASE IN WOMEN CUT IN HALF 2
Publisher's abstract: Journal
of the American Medical Association. 1998; 279(5):359-364
Harvard University researchers tracked
80,084 female nurses over a 14 year period, and found that women
with the highest intake of folate and vitamin B6 cut their risk
of heart attack or death due to coronary heart disease by 45%.
Healthy homocysteine levels can be
maintained with a combination of Folate,
B12 and B6. The body-ready (conenzymated) form of these
vitamins may help overcome obstacles to metabolizing homocysteine.
Publisher's abstract: New
England Journal of Medicine. 1997;337:230-236
Among 587 patients with coronary
artery disease (confirmed by angiography), investigators found
a strong, graded relationship between homocysteine levels and
overall mortality.
HOMOCYSTEINE INCREASES RISK FOR ARTERY DISEASE 4
Publisher's abstract: Journal
of the American Medical Association. 1995; 274(13):1049-57.
The odds for coronary artery disease (CAD) is 60% higher for men and 80% higher for women with a 5-mmol/L increase in homocysteine. The probability for cerebrovascular disease is ~50% higher. Peripheral arterial disease also shows a strong association. Approximately 10% of the population's CAD appears attributable to homocysteine.
MAJORITY WITH ARTERY DISEASE HAVE NORMAL CHOLESTEROL 5
Dr. Kilmer McCully, The Homocysteine Revolution, 1999;115-116
"Practicing physicians know, however, that the majority of their patients with arteriosclerosis have normal or desirable cholesterol levels in the 180-220 range."
Healthy homocysteine levels can be
maintained with a combination of Folate,
B12 and B6. The body-ready (conenzymated) form of these
vitamins may help overcome obstacles to metabolizing homocysteine.
Publisher's abstract: American
Journal of Cardiovascular Drugs. 2001;1(2):85-9
Homocysteine levels above 10.2 mmol/L
are associated with a doubling of coronary risk, and levels
above 20 mmol/L are associated with a 9.9-fold increase in risk
compared with levels below 9 mmol/L.
Limitations and Precautions
- Additional studies are underway to further
demonstrate whether folate intake or lowering homocysteine
levels have a consistent direct, causal role in risk reduction
for cardiovascular disease.
- Important: Taking a B6/B12/Folate supplement
is currently NOT recommended following stent implantation
for those with normal homocysteine due to a conflicting
study showing increased risk of in-stent restenosis. (Lange,
H et al, N Engl J Med. 2004 Jun 24;350(26):2673-81.)
- Intake of more than 1000 mcg/day of folate
can hide symptoms of B12 deficiency. A blood test can measure
serum B12, or see if methylmalonic acid is elevated as a
proxy for functional B12 shortage. Oral supplementation
with 1000 mcg/day of B12 corrects or protects against most
cases of deficiency (except those due to metabolic or serious
malabsorption issues). If untreated, B12 deficiency can
result in nerve damage.
- This article is not intended to replace the
advice or attention of your doctor or other health care
professional. Do not stop taking medications or start taking
a nutrition supplement without first speaking to a qualified
health care professional.
References
1 Wald, D et al. Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. British Journal of Medicine. 2002;325:1202
2 Rimm EB et al. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA. 1998 Feb 4;279(5):359-64.
3Nygard O, Nordrehaug JE, Refsum H, Ueland PM, Farstad M, Vollset SE. Plasma homocysteine levels and mortality in patients with coronary artery disease. N Engl J Med. 1997 Jul 24;337(4):230-6.
4Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes.JAMA. 1995 Oct 4;274(13):1049-57.
5McCully, K. The Homocysteine Revolution, 1999;115-116.
6Spence JD. Patients with atherosclerotic vascular disease: how low should plasma homocyst(e)ine levels go? Am J Cardiovasc Drugs. 2001;1(2):85-9. Review.
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