Insufficient Evidence for the Efficacy of Homocysteine- Lowering Treatment on Cardiovascular Disease: The Homocysteine Hypothesis Revisited

Abstract

A large body of observational studies has suggested that a moderate increaseof plasma total homocysteine (tHcy) concentration is a modest risk factor for CHDand a somewhat stronger risk factor for stroke, at least innonfortified populations. Folic acid and vitamin B6 and B12 supplementation can lower tHcy levels. However,recent clinical trials in populations at high risk for CVD havefailed to show treatment benefits with homocysteine-lowering dietary interventions. There is continued controversy with regard to whether high homocysteine level is a cause of CVD and whether homocysteine-lowering therapy can protect against the development of CVD.