Heart Risk Factor: Homocysteine

by Dr. Stephen Sinatra
Filed Under: Heart Health
Last Reviewed 02/06/2014

Historically, maintaining healthy cholesterol has been at center stage of the quest to minimize the risk of coronary artery disease. But there is now evidence that elevated homocysteine levels are also one of the top heart risk factors.

Multiple studies have confirmed the connection between high-plasma homocysteine levels and occlusive artery disease, including coronary atherosclerosis, peripheral vascular disease, and carotid artery disease. In fact, some research shows that 42 percent of strokes, 28 percent of peripheral vascular disease, and approximately 30 per­cent of premature cardiovascular disease are directly related to excessive levels of homocysteine.

High homocysteine levels can be caused by foods—red meat, avocados, sunflower seeds, wild game, poultry, and ricotta cheese. These foods contain the amino acid methio­nine. If you don’t get enough B vitamins, your body cannot break down methionine, which results in homocysteine.

Research also shows that five percent of the popula­tion may have inherited a rare genetic enzymatic defect that leads to higher homocysteine levels and premature heart disease.

When Should You Get Your Homocysteine Tested?

If you adhere to healthy cardiovascular nutrition, supplement with vitamins and minerals, exercise, and have no family history of heart disease and/or other heart risk factors, then you don’t need to be tested for homocysteine.

But, if there was a sudden death of a family member at a young age from stroke or heart disease, or if you have heart disease (especially if you are under age 60), you should be tested for homocysteine.

Research has shown that 400 mcg of folic acid a day will help prevent high homocysteine levels. However, to be safe, I recommend 800 mcg folic acid and 40 mg of vitamin B6 per day. Natural sources of folate include dark green leafy vegetables, beans, legumes, oranges, orange juice, and fortified cereals.

To read about other heart risk factors and how to prevent them, visit www.drsinatra.com.

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