In this third up date of the Cochrane review , there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6 , B9 or B12 given alone or in combination comparing with placebo on myocardial infa rct ion , death from any cause or adverse events .
BACKGROUND Cardiovascular disease , which includes coronary artery disease , stroke and peripheral vascular disease , is a leading cause of death worldwide .
Homocysteine is an amino acid with biological functions in methionine metabolism .
A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level .
The impact of homocysteine-lowering interventions , given to patients in the form of vitamins B6 , B9 or B12 supplements , on cardiovascular events has been investigated .
This is an up date of a review previously published in 2009 , 2013 , and 2015 .
OBJECTIVES To determine whether homocysteine-lowering interventions , provided to patients with and without pre-existing cardiovascular disease are effective in preventing cardiovascular events , as well as reducing all-cause mortality , and to evaluate their safety .
Effect of physiological doses of oral vitamin B12 on plasma homocysteine: a randomized, placebo-controlled, double-blind trial in India
Background / Objectives : Vitamin B12 ( B12 ) deficiency is common in Indians and a major contributor to hyperhomocysteinemia , which may influence fetal growth , risk of type II diabetes and cardiovascular disease . The purpose of this paper was to study the effect of physiological doses of B12 and folic acid on plasma total homocysteine ( tHcy ) concentration . Subjects/ Methods : A cluster r and omized , placebo-controlled , double-blind , 2 × 3 factorial trial , using the family as the r and omization unit . B12 was given as 2 or 10 μg capsules , with or without 200 μg folic acid , forming six groups ( B0F0 , B2F0 , B10F0 , B0F200 , B2F200 and B10F200 ) . Plasma tHcy concentration was measured before and after 4 and 12 months of supplementation . Results : From 119 families in the Pune Maternal Nutrition Study , 300 individuals were r and omized . There was no interaction between B12 and folic acid ( P=0.14 ) in relation to tHcy concentration change and their effects were analyzed separately : B0 vs. B2 vs. B10 ; and F0 vs. F200 . At 12 months , tHcy concentration reduced by a mean 5.9 ( 95 % CI : −7.8 , −4.1 ) μmol/l in B2 , and by 7.1 ( 95 % CI : −8.9 , −5.4 ) μmol/l in B10 , compared to nonsignificant rise of 1.2 ( 95 % CI : −0.5 , 2.9 ) μmol/l in B0 . B2 and B10 did not differ significantly . In F200 , tHcy concentration decreased by 4.8 ( 95 % CI : −6.3 , −3.3 ) μmol/l compared to 2.8 ( 95 % CI : −4.3 , −1.2 ) μmol/l in F0 . Conclusion : Daily oral supplementation with physiological doses of B12 is an effective community intervention to reduce tHcy .  Folic acid ( 200 μg per day ) showed no additional benefit , neither had any unfavorable effects
In this third up date of the Cochrane review , there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6 , B9 or B12 given alone or in combination comparing with placebo on myocardial infa rct ion , death from any cause or adverse events .
BACKGROUND Cardiovascular disease , which includes coronary artery disease , stroke and peripheral vascular disease , is a leading cause of death worldwide .
Homocysteine is an amino acid with biological functions in methionine metabolism .
A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level .
The impact of homocysteine-lowering interventions , given to patients in the form of vitamins B6 , B9 or B12 supplements , on cardiovascular events has been investigated .
This is an up date of a review previously published in 2009 , 2013 , and 2015 .
OBJECTIVES To determine whether homocysteine-lowering interventions , provided to patients with and without pre-existing cardiovascular disease are effective in preventing cardiovascular events , as well as reducing all-cause mortality , and to evaluate their safety .