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Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis

BMJ · 2002 · Vol. 325(7374) · pp. 1202–1202

David S Wald✉(Southampton General Hospital)Malcolm LawJoan K Morris

Abstract

The genetic studies and the prospective studies do not share the same potential sources of error, but both yield similar highly significant results-strong evidence that the association between homocysteine and cardiovascular disease is causal. On this basis, lowering homocysteine concentrations by 3 micromol/l from current levels (achievable by increasing folic acid intake) would reduce the risk of ischaemic heart disease by 16% (11% to 20%), deep vein thrombosis by 25% (8% to 38%), and stroke by 24% (15% to 33%).

Folate and B Vitamins Research Esophageal and GI Pathology Gastroesophageal reflux and treatmentsHomocysteineMedicineProspective cohort studyOdds ratioMethylenetetrahydrofolate reductaseInternal medicineHyperhomocysteinemiaDeep veinStroke (engine)Pulmonary embolism

MeSH terms

Oxidoreductases Acting on CH-NH Group DonorsHomocysteineHomozygoteHumansMutationProspective StudiesPulmonary EmbolismRisk FactorsCohort StudiesOdds RatioMyocardial IschemiaGenetic Predisposition to DiseaseVenous ThrombosisMethylenetetrahydrofolate Reductase (NADPH2)

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One-Carbon Metabolism in Health and Disease