In a study of 15,000 male U.S. physicians, the 5 percent with the highest homocysteine levels in their blood were found to have three times the risk of having a heart attack compared to those with a lower lever of homocysteine. When the researchers corrected for the other risk factors, a high homocysteine level remained a significant risk. Most commercial labs are now able to test for homocysteine to evaluate this risk. Folic acid, in doses of 1 to 2 milligrams per day, has been found to reduce elevated homocysteine levels. Some experts are recommending folic acid for people with high levels, but since it is difficult to find out if you have a high level, the pathologists are probably just taking it anyway.
Folic acid is safe and also prevents some serious birth defects in pregnant women.
There is considerable interest now in mandating folic acid supplements in milk or foods. This interest is because of the birth defect problem, since no one has yet determined by a controlled study that taking folic acid will reduce the risk of heart attacks. So sure, take folic acid, but realize that controlling cholesterol, hypertension, and smoking are probably still much more important for preventing heart disease. Also be sure to let your doctor know that you are taking folic acid, since it can mask a deficiency of vitamin B12, leading to serious complications in people with pernicious anemia who are unable to absorb vitamin B12. This is one doctor who makes housecalls.