Vitamins and stroke: the homocysteine hypothesis still in doubt

The Neurologist
George NtaiosApostolos Hatzitolios

Abstract

During the last years, many epidemiologic studies have identified homocysteine as an independent risk factor for cardiovascular diseases like coronary events, stroke, and venous thromboembolism. Supplementation with oral folate and vitamins B6 and B12 (mainly folate) reduce plasma homocysteine levels to a significant degree. Recent clinical trials showed that vitamin supplementation leads to slower progression or even regression of atherosclerotic lesions in the carotid arteries, as confirmed by ultrasonographic measurement of carotid intima media thickness. However, the recent Vitamin Intervention for Stroke Prevention (VISP) study failed to show any clinical effect on stroke prevention. It is unclear if homocysteine-lowering therapy really has a role in the prevention of cardiovascular diseases. Large trials, which are already conducted, will probably give the definitive answer. In this review, we try to keep pace with the data that make the homocysteine hypothesis still doubtful.

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Citations

Jun 27, 2009·Nutrition Research Reviews·Concepción Sánchez-MorenoAntonio Martín
Jul 30, 2009·The Tohoku Journal of Experimental Medicine·Nida TascilarAysun Unal
Jun 10, 2010·Vascular Health and Risk Management·Mabrouka El OudiSalem Machghoul
Dec 8, 2009·Archives of Cardiovascular Diseases·George NtaiosApostolos Hatzitolios
Jul 17, 2012·European Journal of Pharmacology·Biqi ZhangShenjiang Hu
Sep 16, 2011·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Maogang ChenXinfeng Liu
Mar 3, 2009·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Arijit BiswasRenu Saxena
Feb 25, 2009·European Journal of Internal Medicine·George NtaiosApostolos Hatzitolios
Jan 10, 2014·Anesthesiology·Philip J Peyton, Christine Yx Wu

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