A New Medical Frontier?

It's well known that stopping smoking and lowering cholesterol level and high blood pressure help prevent cardiovascular disease. Studies have shown that a high level of homocysteine, an amino acid, in the blood is associated with cardiovascular risk. Other studies have shown that high homocysteine levels can be lowered by simple, inexpensive therapy with folic acid as well as with vitamins B6 and B12. Does lowering the homocysteine level therefore reduce risk for heart disease? Seven large randomized clinical trials currently in progress may answer this question. Meanwhile, seven selections in the Sept. 7 issue of Annals explore what is known about the tantalizing relationship between homocysteine, vitamins and cardiovascular risk.

An editorial concludes that high-risk persons with elevated plasma homocysteine levels should probably take folic acid supplements, and the rest of us should eat plenty of fruits and vegetables, good sources of folic acid, "just as our parents always told us."

Contents

• "Homocyst(e)ine and Cardiovascular Disease: A Critical Review of the Epidemiologic Evidence" (Review, p. 363)
• "Potential New Cardiovascular Risk Factors" (Review, p. 376)
• "Nonfasting Plasma Total Homocysteine Level and Mortality in Middle-aged and Elderly Men and Women in Jerusalem" (Article, p. 321)
• "Population Reference Ranges and Contribution of Vitamin Status to High Serum Concentrations" (Article, p. 331)
• "Normalization of Hyperhomocysteinemia with L-Thyroxine in Hypothyroidism" (Brief Communication, p. 348)
• "Nonfasting Plasma Total Homocysteine Levels and Stroke Incidence in Elderly Persons: The Framingham Study" (Brief Communication, p. 352)
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