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Vitamins as Homocysteine-Lowering Agents¹

Department of Medicine, County Hospital, S-391 85 Kalmar, Sweden

Moderate hyperhomocysteinemia is, today, considered an established risk factor for cardiovascular disease. A graded dose-response relationship between plasma homocysteine concentration over its full range and cardiovascular risk strongly supports causality. Therefore, intervention studies with homocysteine-lowering vitamins are needed. This mini review shows that supplementation with folic acid not only markedly reduces elevated plasma homocysteine concentrations but also reduces normal homocysteine concentrations. Folic acid doses of <1 mg/d may be effective. Supplementation with a combination of folic acid and cyanocobalamin will secure full homocysteine-lowering effect and prevent occurrence of vitamin B-12 deficiency during the course of therapy.

KEY WORDS: • homocysteine • folate • folic acid • vitamin B-12 • vitamin B-6

¹ Presented as part of the colloquium "Homocyst(e)ine, Vitamins and Arterial Occlusive Diseases" given at the Experimental Biology '95 meeting, Atlanta, GA, on April 13, 1995. This symposium was sponsored by the American Institute of Nutrition. Guest editors for the symposium were M. R. Malinow, Oregon Regional Primate Research Center, Beaverton, OR, and M. J. Stampfer, Harvard School of Public Health, Cambridge, MA.

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