Yet Another Study of Lowering Homocysteine to Prevent Vascular Disease

Higher blood levels of homocysteine clearly are associated with higher risk for cardiovascular (CV) disease, but seven major randomized trials have shown no benefit for lowering homocysteine levels with folic acid. Despite the accumulating evidence, these studies have been criticized as being too small, too short, or insufficiently controlled to show a true benefit. U.K. investigators randomized about 12,000 high-risk patients (survivors of myocardial infarction [MI]; mean age, 64) to daily folic acid (2 mg) plus vitamin B₁₂ (1 mg) or placebo. Patients with major chronic diseases or cancer or unexpectedly low cholesterol levels were excluded.

During a mean 7 years of follow-up, folate and vitamin B₁₂ levels rose two- to threefold and homocys…