The hyperhomocysteinemia as a cardiovascular risk factor: actual perspectives

Abstract

Homocysteine, an intermediate of metionine metabolism, is considered, without a universal consent, an independent risk factor for ischemic cardiopathy. In order to review the literature, we conducted a bibliographical research interested in the association between hyperhomocysteinemia and cardiovascular risk. Conclusively, the hyperhomocysteinemia

determines greater protein and LDL-cholesterol homocysteinilation, inducing specific auto-antibodies against homocysteinilated proteins and higher circulating levels of oxidized LDL-cholesterol, increasing the chances of vascular atherosclerosis. This association seems to depend, intrinsically, on the levels of two important co-factors involved in the methyl cycle, folic acid and cobalamin. Individuals with hyperhomocysteinemia, once supplemented with these vitamins, have reduced their cardiovascular risk and global mortality. However, this beneficial action seems to be restricted to people that use it as a form of primary prevention, since its use in individuals with atherosclerotic coronary artery disease did not reduce the incidence of ischemic events or mortality rates. It is concluded that the hiperhomocisteinemia is an independent cardiovascular risk factor, and should therefore be treated early, before the development of ischemic symptoms, with folic acid and cobalamin supplementation in order to control their serum levels and thus reduce the intrinsic cardiovascular risk. This seems to be important mainly in those individuals that, besides the hyperhomocysteinemia, carry others habitual risk factors for vascular atherosclerosis.