Homocysteinemia as a Risk Factor for Atherosclerosis: A Review

Elevation in plasma homocysteine has been widely studied as an independent risk factor for atherosclerosis. Animal laboratory models have demonstrated rapid onset vascular lesions with homocysteine infusion. A large body of data indicates a consistent relationship between plasma homocysteine and symptomatic atherosclerotic disease involving the coronary, peripheral, and cerebral circulations. Elevated plasma homocysteine can be predictably normalized with oral folate in most patients. Despite the wealth of published clinical data on this topic, it is unknown if normalization of plasma homocysteine in patients with symptomatic atherosclerosis will prevent or arrest the disease process.