Folic Acid Decreases Homocysteine and Risk for Cardiovascular Conditions

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Folic Acid Decreases Homocysteine and Risk for Cardiovascular Conditions

The amino acid homocysteine, measured through serum concentration, has been linked to risk for deep vein thrombosis, stroke, pulmonary embolism and ischemic heart disease.

Determining whether homocysteine concentrations are causal for these conditions is valuable, because evidence suggests homocysteine can be lowered through folic acid supplementation - a simple and safe preventive regimen.

Using 92 studies involving a total of over 20,000 adult subjects, the authors of this study evaluated the possible causation of the above conditions from high serum homocysteine levels. For every unit increase in serum homocysteine, the odds were increased for:

ischemic heart disease (1.42 times in genetic studies and 1.32 times in prospective studies);

deep vein thrombosis with/without pulmonary embolism (1.6 times in genetic studies); and

stroke (1.65 times in genetic studies, 1.59 in prospective studies).

The authors conclude that there is good evidence that the link between homocysteine and cardiovascular disease is a causal one. They suggest that lowering homocysteine concentrations by even less than one unit (by increasing folic acid intake) may reduce the risk of ischemic heart disease by approximately 16%, deep vein thrombosis by 25%, and stroke by 24%.

Note: Several nice tables clearly depicting the risk of cardiovascular conditions associated with elevated homocysteine levels are included in the original publication, available free on the Internet.

Wald DS, Law M, Morris JK. Homocysteine and cardiovascular disease: Evidence on causality from a meta-analysis. British Medical Journal 2002:325, pp. 1202-1208.
http://bmj.com