Is a high homocysteine level bad for my heart?
Elevated homocysteine is associated with a higher risk of cardiovascular disease, but whether you can reduce that risk by lowering homocysteine with folic acid has not been proven on the basis of these studies. Have an elevated value discussed with your general practitioner.
In studies of people who had a heart attack at a young age and few other risk factors, 24% turned out to have elevated homocysteine. Summarised across approximately 80 clinical and population studies involving more than 10,000 patients, it appears that elevated homocysteine is an independent risk factor for atherosclerosis, heart attack, and thrombosis, with no clear threshold below which you are safe. The effect also seems to amplify other risk factors such as smoking and high blood pressure.
Yet the picture is not straightforward. Retrospective and cross-sectional studies show the association most strongly. Studies in which people were followed for years are more contradictory, particularly for thrombosis and coronary heart disease. Whether high homocysteine actually causes the damage, or is merely a signal that something is wrong, has therefore not yet been established.
Folic acid, optionally supplemented with vitamin B6 and B12, demonstrably and safely lowers homocysteine in the blood. That is a solid finding. The crucial point, however, is what this means for your heart: studies up to around 2000 could NOT prove that lower homocysteine also led to fewer heart attacks or deaths. The randomised trials needed to answer that question were either still ongoing or had not yet been conducted at that time.
In short: elevated homocysteine is a serious signal that your heart and blood vessels are not entirely in order, but whether lowering it through supplementation actually protects your heart could not be determined on the basis of these studies. If a blood test has revealed an elevated homocysteine level, discuss it with your general practitioner, especially if you also have other risk factors.
All sources are reviews or early observational studies (no meta-analyses or randomised trials). The direct association with cardiovascular disease is moderately consistent; the question of whether lowering homocysteine also provides clinical protection remains unanswered on the basis of these sources.
Does having bad gums affect my heart?
There is a plausible association between severe gum disease and heart problems, but no proven causal relationship. Good oral care is sensible, but whether treating gum disease lowers your cardiac risk has not yet been demonstrated.
Is a calcium score of my heart worth doing?
For people aged 40 to 75 in a grey zone regarding statins, a calcium score is a well-supported tool for making a considered decision about medication together with your doctor.
How harmful is prolonged stress really for my heart?
Long-term stress measurably increases your risk of cardiovascular disease, particularly through work-related stress (10-40% extra risk in large population studies). The effect is real, but smaller than that of smoking or high blood pressure.
Is coffee good or bad for your heart?
For most healthy adults, three to four filtered cups per day are associated with a beneficial effect on the heart and blood vessels. Pregnant women are an important exception: for them, the maximum is one to two cups per day.
What does my CRP value (inflammation) say about my heart?
A high hsCRP value points to chronic inflammation and predicts a clearly elevated long-term risk of cardiovascular problems, even more strongly than well-known cholesterol values. It is an independent risk factor that deserves serious attention.
Is the Mediterranean diet really good for your heart, and why?
For people with an elevated cardiovascular risk, the Mediterranean diet is the best-supported dietary choice currently available. Both large trials and dozens of population studies confirm a lower risk of heart attack and stroke.