Homocysteine and vascular disease: Review of published results of the homocysteine-lowering trials
Moderately elevated homocysteine levels have been associated with a higher risk of cardiovascular disease in observational studies, but whether these associations are causal is uncertain. Randomized trials of dietary supplementation with B vitamins were set up to assess whether lowering homocysteine...
| Main Authors: | , , , |
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| Format: | Journal article |
| Language: | English |
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2011
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| _version_ | 1826267164835840000 |
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| author | Clarke, R Halsey, J Bennett, D Lewington, S |
| author_facet | Clarke, R Halsey, J Bennett, D Lewington, S |
| author_sort | Clarke, R |
| collection | OXFORD |
| description | Moderately elevated homocysteine levels have been associated with a higher risk of cardiovascular disease in observational studies, but whether these associations are causal is uncertain. Randomized trials of dietary supplementation with B vitamins were set up to assess whether lowering homocysteine levels could reduce the risk of vascular disease. This review is based on a meta-analysis of published results of eight homocysteine-lowering trials for preventing vascular disease. The eight trials comprised a total of 37,485 individuals and provided comparisons of the effects of B vitamins on 5,074 coronary heart disease (CHD) events, 1,483 stroke events, 2,692 incident cancer events, and 5,128 deaths. Our meta-analysis assessed the effects of lowering homocysteine levels by about 25% for about 5 years. Allocation to B vitamins had no beneficial effects on any cardiovascular events, with hazard ratios (95% confidence intervals) of 1.01 (0.96-1.07) for CHD and 0.96 (0.87-1.07) for stroke. Moreover, allocation to B vitamins had no significant adverse effects on cancer [1.08 (0.99-1.17)], or for death from any cause [1.02 (0.97-1.07)]. Thus, supplementation with B vitamins had no statistically significant effects on the risks of cardiovascular events, total mortality rates, or cancer. A meta-analysis based on individual participant data from all available trials will assess the effects of lowering homocysteine levels on a broader range of outcomes, overall and in all relevant subgroups. However, available evidence does not support the routine use of B vitamins to prevent cardiovascular disease. © SSIEM and Springer 2010. |
| first_indexed | 2024-03-06T20:50:02Z |
| format | Journal article |
| id | oxford-uuid:3740a137-3f8d-4dfc-aacc-dd6ea580968b |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T20:50:02Z |
| publishDate | 2011 |
| record_format | dspace |
| spelling | oxford-uuid:3740a137-3f8d-4dfc-aacc-dd6ea580968b2022-03-26T13:42:58ZHomocysteine and vascular disease: Review of published results of the homocysteine-lowering trialsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3740a137-3f8d-4dfc-aacc-dd6ea580968bEnglishSymplectic Elements at Oxford2011Clarke, RHalsey, JBennett, DLewington, SModerately elevated homocysteine levels have been associated with a higher risk of cardiovascular disease in observational studies, but whether these associations are causal is uncertain. Randomized trials of dietary supplementation with B vitamins were set up to assess whether lowering homocysteine levels could reduce the risk of vascular disease. This review is based on a meta-analysis of published results of eight homocysteine-lowering trials for preventing vascular disease. The eight trials comprised a total of 37,485 individuals and provided comparisons of the effects of B vitamins on 5,074 coronary heart disease (CHD) events, 1,483 stroke events, 2,692 incident cancer events, and 5,128 deaths. Our meta-analysis assessed the effects of lowering homocysteine levels by about 25% for about 5 years. Allocation to B vitamins had no beneficial effects on any cardiovascular events, with hazard ratios (95% confidence intervals) of 1.01 (0.96-1.07) for CHD and 0.96 (0.87-1.07) for stroke. Moreover, allocation to B vitamins had no significant adverse effects on cancer [1.08 (0.99-1.17)], or for death from any cause [1.02 (0.97-1.07)]. Thus, supplementation with B vitamins had no statistically significant effects on the risks of cardiovascular events, total mortality rates, or cancer. A meta-analysis based on individual participant data from all available trials will assess the effects of lowering homocysteine levels on a broader range of outcomes, overall and in all relevant subgroups. However, available evidence does not support the routine use of B vitamins to prevent cardiovascular disease. © SSIEM and Springer 2010. |
| spellingShingle | Clarke, R Halsey, J Bennett, D Lewington, S Homocysteine and vascular disease: Review of published results of the homocysteine-lowering trials |
| title | Homocysteine and vascular disease: Review of published results of the homocysteine-lowering trials |
| title_full | Homocysteine and vascular disease: Review of published results of the homocysteine-lowering trials |
| title_fullStr | Homocysteine and vascular disease: Review of published results of the homocysteine-lowering trials |
| title_full_unstemmed | Homocysteine and vascular disease: Review of published results of the homocysteine-lowering trials |
| title_short | Homocysteine and vascular disease: Review of published results of the homocysteine-lowering trials |
| title_sort | homocysteine and vascular disease review of published results of the homocysteine lowering trials |
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