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 .
Homocysteine Lowering by Folate-Rich Diet or Pharmacological Supplementations in Subjects with Moderate Hyperhomocysteinemia
Background / Objectives : To compare the efficacy of a diet rich in natural folate and of two different folic acid supplementation protocol s in subjects with “ moderate ” hyperhomocysteinemia , also taking into account C677 T polymorphism of 5,10-methylenetetrahydrofolate reductase ( MTHFR ) gene . Subjects/ Methods : We performed a 13 week open , r and omized , double blind clinical trial on 149 free living persons with mild hyperhomocyteinemia , with daily 200 μg from a natural folate-rich diet , 200 μg [6S]5-methyltetrahydrofolate ( 5-MTHF ) , 200 μg folic acid or placebo . Participants were stratified according to their MTHFR genotype . Results : Homocysteine ( Hcy ) levels were reduced after folate enriched diet , 5-MTHF or folic acid supplementation respectively by 20.1 % ( p < 0.002 ) , 19.4 % ( p < 0.001 ) and 21.9 % ( p < 0.001 ) , as compared to baseline levels and significantly as compared to placebo ( p < 0.001 , p < 0.002 and p < 0.001 , respectively for enriched diet , 5-MTHF and folic acid ) . After this enriched diet and the folic acid supplementation , Hcy in both genotype groups decreased approximately to the same level , with higher percentage decreases observed for the TT group because of their higher pre-treatment value . Similar results were not seen by genotype for 5-MTHF . A significant increase in RBC folate concentration was observed after folic acid and natural folate-rich food supplementations , as compared to placebo . Conclusions : Supplementation with natural folate-rich foods , folic acid and 5-MTHF reached a similar reduction in Hcy concentrations
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 .