Can Lowering Homocysteine Levels Reduce Cardiovascular Risk?

High serum cholesterol levels are an important risk factor for coronary disease, but most patients with myocardial infarction have normal cholesterol levels. Despite considerable advances in our understanding of the causes of cardiovascular disease, the established risk factors cannot fully explain its occurrence. The article by Selhub and colleagues1 in this issue of the Journal contributes importantly to the rapidly accumulating evidence that elevated blood levels of homocysteine increase the risk of vascular disease.The original hypothesis, proposed by McCully,2 was based on postmortem findings of arteriosclerotic disease in patients with extraordinarily high blood homocysteine levels due to rare metabolic . . .