Background: For the last few years, cardiologists have been following a blood test called homocysteine, as a risk indicator for heart and stroke. Previous studies have showed an association between lower homocysteine levels and lower coronary heart disease. However, no studies have yet been able to prove a benefit (i.e. less heart disease) from interventions which lower homocysteine.
This week, in JAMA, the latest study on this topic was published. It was a double-blinded, randomized, placebo-controlled trial (the best kind) of 12,000+ people who had previously survived a heart attack. They were given vitamin b12 and folate supplements, which are known reduce homocysteine levels by about 30%. During the 6.7 years of follow up, it was found that even though the blood levels of homocysteine were lowered by about 28%, there were no apparent beneficial effects on major coronary events or other non-coronary vascular events. The vitamin supplements didn’t cause any harm, though, with no changes in mortality or the appearance of other cancers.
Sadly, the vitamins didn’t help. The homocysteine molecule itself doesn’t seem to have a direct effect on the heart.
What does this mean? We have to focus on what actually has been proven to work when it comes to risk reduction for heart disease: lifestyle changes (like avoiding excessive weight gain and quitting smoking), controlling blood pressure and cholesterol, and so on. Vitamin B12 and folate supplements, unfortunately, are not the magic bullets.