Homocystein (2004) & Heart Disease

Learn more about atherosclerosis.

A number of studies have demonstrated that patients who have coronary heart disease have higher homocysteine levels in their blood plasma than controls without heart disease. The International Task Force for Prevention of Coronary Heart Disease reported:

  • A meta-analysis (an averaging of many studies, or a study of studies) verfied that increased homocysteine by 5 micrometer/l doubled heart disease risk. (Boushey et al.; JAMA 1995; 274:1049-1057)
  • Heart disease patients with a level of homocysteine lower than 9 micrometer/l had a much better life expectancy than those with levels above 20 micrometer/l. (Nygard et al., NEJM 1997; 337:230-236)
  • Blood levels of vitamins B6 and B12 and folate are correlated with blood homocysteine concentration levels. (ARIC Study: Folsom et al.; Circulation 1998; 98: 204-210)
  • Low levels of vitamin B6 are a more important risk factor than high homocysteine levels and these high levels reflect the cardiovascular risk created by vitamin B6 deficiency. (ARIC Study: Folsom et al. Circulation, 1998, 98: 204-210)
  • High homocysteine levels may also be a risk factor for stroke, and that the higher the level the greater the risk. (British Regional Heart Study, Perry et al. Lancet, 1995, 346: 1395-1398)
  • Folic acid treatment appears to be effective in reducing homocysteine levels. (Homocysteine Lowering Trialist's Collaboration. Br. Med J. 1998; 316:894-898)
  • Patients with homocysteine levels greater 12 micrometer/l should increase and/or supplement their dietary intake of folic acid and those with homocysteine levels greater 30 micrometer/l should receive daily doses of 400-800mg folic acid, 2-4mg vitamin B6 and 400mg vitamin B12. (Nutrition, Metabolism, and Cardiovascular Disease 1998, 8:212-271)
  • Mild homocystein elevation levels can be treated with attention to diet. See food sources for folic acid and vitamins B6 and B12.