Increase in homocysteine level raises heart disease risk

Pamela Egan Practical Practitioner

 

By: Pamela Egan, FNP-C CDE

 


 

Increase in homocysteine level raises heart disease risk

 

 

Dear Pam,

I’ve been told that my homocysteine is elevated and I am taking folic acid. What happens when my homocysteine is elevated?


Some studies have shown that for each 5 mmol/l increase in homocysteine levels, your risk for heart disease can increase by as much as 60 to 80 percent.

In a comparison with cholesterol levels, a recent analysis indicated that a 5 mmol/l increase in homocysteine was equivalent to an approximate 20 mg/dl increase in total cholesterol.

High levels of homocysteine have been shown to be an independent risk factor for heart disease and should be considered as a serious condition. Homocysteine injures arterial walls. Injured arterial cells more readily absorb LDL or “bad” cholesterol. Homocysteine promotes the growth of smooth muscle cells in the artery, which ultimately narrows the vessel. It also increases the risk of blood clot formulation, which can lead to a heart attack or stroke.

Diseases of the heart and blood vessels remain the number one health problem in the United States. Heart Disease can cause heart attacks, strokes, kidney failure and other serious conditions that can lead to disability or death.

Because of this, medical researchers continue to work to identify those risk factors that may reduce the chance of developing heart disease.

Adequate levels of folic acid and vitamins B12 and B6 may play a significant role in decreasing homocysteine levels and cardiovascular risk. Folic acid and vitamin B12 work to reduce homocysteine levels by metablolizing it back to the amino acid, methionine. Vitamin B6 also facilitates the breakdown of homocysteine to cysteine and other waste products.

So what is homocysteine? Homocysteine is an amino acid released as the body digests protein.

While the body requires normal levels of homocysteine to build and maintain tissues, increased amounts can be harmful.

Too much homocysteine in the blood has been found to be associated with increased risk of heart disease, stroke and blood vessel disease in men and women. The risk of heart disease increases in people with high levels of homocysteine who also smoke cigarettes and or have high blood pressure.

Some scientists think that homocysteine causes damage to blood vessels, which can trigger blood clots.

Studies have shown that homocysteine levels in the blood are strongly influenced by the vitamin cofactors: folic acid, cobalamin (B12), pyridoxine HCL (B6). Since these co-factors help break down homocysteine in the body, increased intake of these co-factors has been associated with lower levels of homocysteine in the blood.

The American Heart Association has indicated that a reasonable therapeutic goal, especially for those patients at an increased risk for heart disease, should be less than 10 mmol/l.


This article was originally published August 16, 2004 in The St. Tammany News.

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