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Volume 355:205-211 July 13, 2006 Number 2
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Homocysteine, B Vitamins, and Cardiovascular Disease

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To the Editor: In light of the numerous observational studies that have found a positive association between plasma homocysteine levels and the risk of cardiovascular disease, the results of two homocysteine-lowering trials — the Heart Outcomes Prevention Evaluation 2 (HOPE-2) and the Norwegian Vitamin (NORVIT) trials (April 13 issue)1,2 — are disappointing. The relationship between homocysteine and dementia offers a similar paradox. Observational studies have shown positive associations, whereas homocysteine lowering with folic acid and B vitamins has revealed no cognitive benefit.3

However, the negative outcomes of these trials may not come as a complete surprise. Studies of genetic association . . . [Full Text of this Article]



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