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High homocysteine levels are strongly associated with all-cause mortality among elderly

A high serum level of total homocysteine (tHcy) is generally accepted as a predictor of cardiovascular disease (CVD) risk. In a 4-year prospective study of 4,766 Norwegian subjects initially aged 65-67 years old, Vollset et al. found a strong association of elevated tHcy and all-cause mortality. Their results reinforce the importance of addressing the tHcy problem from a wider perspective than that of CVD risk alone.

At its inception in 1992-1993, the study included 2127 men and 2639 women. On the basis of self-reported medical histories, the participants were divided into groups at high risk for a CVD event (1448) and those at low risk (3318). The subjectswere divided into quintiles of tHcy concentration ranging from 9.0 µmol/L to ³ 20 µmol/L. During an average of 4.1 years of follow-up, 162 men and 97 women died. A progressive association was found between quintiles of serum tHcy and both CVD and non-CVD causes of death. For example, among those in the highest quintile of tHcy concentration, there was a 104% increase in mortality from all noncancer and noncardiovascular causes. The subjects with the highest tHcy levels had a 21% increase in all-cause mortality, in comparison to a 10% increase in the low-risk group. Based on their analysis, Vollset et al. predicted a 49% increase in all-cause mortality for every 5 µmol/L increase in tHcy.

An accompanying editorial by Malinow underscores the significance of this finding, amd suggests that widespread screening of plasma tHcy in middle-aged and elderly persons be conducted to help identify potential candidates for therapy with tHcy-lowering folic acid supplementation.

Vollset, Stein Emil et al. Plasma total homocysteine and cardiovascular and noncardiovascular mortality: the Hordaland Homocysteine Study. Am J. Clin Nutr 2001;74:130-13

Malinow, M Rene. Plasma concentrations of total homocysteine predict mortality risk. Am J Clin Nutr 2001;74:1-3.

This media release is provided by The American Society for Clinical Nutrition, Inc., to provide current information on nutrition-related research. This information should not be construed as medical advice. If you have a medical concern, consult your doctor. To see the complete text of this article, please go to:

http://faseb.org/ajcn/July/12458-Vollset.pdf
http://faseb.org/ajcn/July/12800-Blackburn.pdf

For more information, please contact: stein.vollset@uib.no or malinowr@ohsu.edu

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