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The normal range of blood homocysteine is roughly from 5 to 15 µmol/L; average levels in the U.S. are slightly higher in men than in women, and substantially higher in elderly people than in young adults (Am J Clin Nutr Nov; 84:989). In epidemiologic studies, elevated blood levels are associated with increased cardiovascular risk. Because intake of several B vitamins (particularly folate, B6, and B12) lowers homocysteine levels, two randomized trials tested the hypothesis that vitamin B supplementation would reduce risk for adverse cardiovascular events.
The HOPE-2 trial involved more than 5500 patients with histories of documented vascular disease or with diabetes plus another risk factor. After 5 years, mean homocysteine levels dropped fro…