Cardiovascular
Plaque
[see also Heart
Disease, Stroke, Blood
Pressure]
PLAQUE PROGRESSION REVERSED 1
Publisher's abstract: American
Journal of Hypertension. 2000;13(1 Pt 1):105-10
Ultrasound measurement of carotid
plaque confirmed that daily doses of three B vitamins reversed
the progression of plaque in patients with elevated homocysteine
levels. Plaque regression was achieved with 2.5 mg folate, 25
mg B6, and 250 mcg B12 daily (see precaution).
The authors stated that the results support a causal relationship
between homocysteine and atherosclerosis.
Healthy homocysteine levels can be
maintained with a combination of Folate,
B12 and B6. The body-ready (conenzymated) form of these
vitamins may help overcome obstacles to metabolizing homocysteine.
Publisher's abstract: New
England Journal of Medicine. 2004;350(26):2708-10.
A regimen of folate, vitamin B-12
and vitamin B-6 prevented recurrence of blocked arteries in
patients who had undergone coronary angioplasty. Patients taking
the vitamin combination over the six-month study showed a 48%
reduction in the development of restenosis, or renarrowing of
the arteries, compared with patients receiving the placebo.
The vitamin regimen decreased by 38% the need for repeat angioplasties
or heart-bypass operations. [Participants were randomly assigned
to receive a combination of 400 mcg cyanocobalamin, 10 mg vitamin
B6, and 1 mg folate daily.] Important: Taking a B6/B12/Folate
supplement is currently NOT recommended following stent implantation
due to to a conflicting study showing increased risk of restenosis.
3
HOMOCYSTEINE LEVELS PREDICT CAROTID ARTERY
PLAQUE IN ADULTS WITHOUT HISTORY OF
HEART DISEASE RISK 4
Publisher's abstract: Circulation.
1993;87(4):1107-13
Study subjects with no history of atherosclerotic disease were selected from a probability sample of 15,800 men and women 45 to 64 years old. Subjects with the highest 20% of homocysteine levels (> 10.5 mmol/L) were THREE TIMES more likely to have a thickened carotid artery wall than those in the bottom quintile (< 5.88 mmol/L).
EFFECT OF VITAMIN THERAPHY ON PLAQUE MEASUREMENTS 5
Publisher's abstract:
Clin Chem Lab Med. 2003;41(11):1498-504
Carotid plaque cross-sectional area measurement was used to gauge effects of vitamin therapy in patients whose plaque had been progressing despite intensive treatment of traditional risk factors. Therapy with Folate, B12 and B6 halted progression of atherosclerosis over the 2.5-year study.
UNEXPLAINED CAROTID PLAQUE ATTRIBUTED
TO HOMOCYSTEINE 6
Publisher's abstract: Atherosclerosis.
1999;144(2):429-34
Based on measurement of carotid plaque area, subjects classified as having 'unexplained atherosclerosis' (hardening of the arteries that could not be attributed to traditional risk factors) were found to have significantly higher average concentration of homocysteine.
Healthy homocysteine levels can be
maintained with a combination of Folate,
B12 and B6. The body-ready (conenzymated) form of these
vitamins may help overcome obstacles to metabolizing homocysteine.
Publisher's abstract: Atherosclerosis.
1975; 22:215-227.
Homocysteine damages blood vessel walls and, says McCully, sets the stage for subsequent cholesterol deposits.
Limitations and Precautions
- Additional studies are underway to further
demonstrate whether folate intake or lowering homocysteine
levels have a consistent direct, causal role in preventing
or reducing cardiovascular plaque.
- Important: Taking a B6/B12/Folate supplement
is currently NOT recommended following stent implantation
for individuals with normal homocysteine levels due to a
conflicting study showing increased risk of in-stent restenosis.
(Lange,
H et al, N Engl J Med. 2004 Jun 24;350(26):2673-81.)
- Intake of more than 1000 mcg/day of folate
can hide symptoms of B12 deficiency. A blood test can measure
serum B12, or see if methylmalonic acid is elevated as a
proxy for functional B12 shortage. Oral supplementation
with 1000 mcg/day of B12 corrects or protects against most
cases of deficiency (except those due to metabolic or serious
malabsorption issues). If untreated, B12 deficiency can
result in nerve damage.
- This article is not intended to replace the
advice or attention of your doctor or other health care
professional. Do not stop taking medications or start taking
a nutrition supplement without first speaking to a qualified
health care professional.
References
1 Hackam DG, Peterson JC, Spence JD. What level of plasma homocyst(e)ine should be treated? Effects of vitamin therapy on progression of carotid atherosclerosis in patients with homocyst(e)ine levels above and below 14 micromol/L. Am J Hypertens. 2000 Jan;13(1 Pt 1):105-10.
2 Herrmann HC. Prevention of cardiovascular events after percutaneous coronary intervention. N Engl J Med. 2004 Jun 24;350(26):2708-10.
3 Lange, H. Folate Therapy and In-Stent Restenosis after Coronary Stenting. N Engl J Med. 2004 Jun 24;350(26):2673-81.
4 Malinow MR, Nieto FJ, Szklo M, Chambless LE, Bond G. Carotid artery intimal-medial wall thickening and plasma homocyst(e)ine in asymptomatic adults. The Atherosclerosis Risk in Communities Study. Circulation. 1993 Apr;87(4):1107-13.
5 Spence JD, Blake C, Landry A, Fenster A. Measurement of carotid plaque and effect of vitamin therapy for total homocysteine. Clin Chem Lab Med. 2003 Nov;41(11):1498-504.
6 Spence JD, Barnett PA, Bulman DE, Hegele RA. An approach to ascertain probands with a non-traditional risk factor for carotid atherosclerosis. Atherosclerosis. 1999 Jun;144(2):429-34.
7 McCully KS, Wilson RB. Homocysteine theory of arteriosclerosis. Atherosclerosis, 1975; 22:215-227
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