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International Journal of Epidemiology 2002;31:70-71
© International Epidemiological Association 2002

Special Theme: Systematic Reviews and Meta-Analysis

Commentary: An updated review of the published studies of homocysteine and cardiovascular disease

Robert Clarke

Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Radcliffe Infirmary, Oxford, England.

Dr Robert Clarke, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Clinical Medicine, Radcliffe Infirmary, Oxford OX2 6HE, England. E-mail: robert.clarke@ctsu.ox.ac.uk

Over the last decade, evidence has accumulated that elevated plasma total homocysteine concentrations are associated with an increased risk of atherosclerotic and thromboembolic events.1–3 Plasma homocysteine concentrations reflect genetic and environmental factors including diet. Vitamin supplementation with folic acid and vitamin B-12 achieves substantial reductions in blood homocysteine concentrations.4 Several large-scale clinical trials are currently under way to assess whether vitamin supplementation to lower homocysteine concentrations can reduce vascular risk.5 Accurate estimates of the likely strength of association of homocysteine with cardiovascular disease are necessary for . . . [Full Text of this Article]

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