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KUOPIO, FINLAND. Considerable controversy still surrounds the question as to whether a high
homocysteine level is a risk factor for heart disease. Several studies have concluded that it is, while others
have found no association. Homocysteine is a sulfur-containing amino acid synthesized from methionine,
an essential amino acid found mainly in red meat. Homocysteine requires folic acid, vitamin B6, and vitamin
B12 as cofactors during its metabolism and a deficiency of any of these vitamins can lead to high
homocysteine levels. Conversely, homocysteine levels can be effectively lowered by supplementing with
folic acid, vitamin B6, and vitamin B12.
Finnish researchers have just completed an 8-year study involving 1027 men between the ages of 46 to 64
years and free of cardiovascular disease at enrollment in 1991-1993. The study was designed to determine
the effect of homocysteine and folate levels on the incidence of acute cardiac events (heart attack or stroke).
During the 7.7-year study period, 61 men experienced an acute cardiac event. Analysis of blood levels of
homocysteine and folic acid showed no correlation between the incidence of acute cardiac events and
homocysteine levels, but did reveal a highly significant 61% risk reduction among men with a folate level
exceeding 11.3 nmol/L as compared to men with a level below 8.4 nmol/L. The researchers conclude that
further trials are needed to determine whether the use of vitamin supplementation to reduce homocysteine
concentrations prevents heart disease or whether high homocysteine levels and low folate levels are simply
markers of an unhealthy lifestyle that increase the risk of heart disease.
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