Information On Homocysteine (High)

Information On Homocysteine (High)
A high serum concentration of homocysteine is associated with increased risk for Coronary Heart Disease (CHD).
The AHA recently published an advisory on homocysteine that provides an
in-depth review of the relation between homocysteine and CVD. Several
mechanisms whereby elevated homocysteine predisposes to CVD have been
postulated. However, it remains to be proved in controlled clinical
trials that a reduction in serum homocysteine levels will reduce risk
for CHD. In some patients, nonetheless, high levels of homocysteine can
be lowered by recommended daily intake of folic acid. If homocysteine
levels are elevated, patients should be encouraged to consume the
recommended daily intake of folic acid, as well as vitamins B6 and B12.
Routine measurement of homocysteine levels was not recommended for
purposes of risk assessment, but measurement is optimal in high-risk
patients.

The observation that many heart attack victims have normal
cholesterol levels underscores the need to identify other risk factors
for atherosclerosis. Of several
substances in the blood that are now thought to predict odds for
vascular disease, the amino acid, homocysteine, is the one for which
the case is strongest. The findings suggest a simple way to prevent
heart attacks because homocysteine levels can be lowered by taking the
B vitamin, folic acid. In a 1995 review of work exploring the
relationships among homocysteine levels, folic acid and blood vessel
disease (JAMA, vol. 274, pp.1049-1057), University of Washington
researchers proposed that increasing folic acid intake might prevent as
many as 50,000 heart attack deaths a year.

An important risk factor for vascular disease is elevated blood
concentrations of homocysteine, and one of the risk factors for
hyperhomocysteinemia is inadequate intake of the vitamins involved in
homocysteine metabolism. Homocysteine is an intermediate in the
interconversion of the amino acids methionine and cysteine, a process
requiring at various stages, activated folic acid (tetrahydrofolate and
N-methyl-tetrahydrofolate) and enzymes containing the cofactors vitamin
B6 (pyridoxal phosphate) and vitamin B12 (methyl- cobalamin).
Homocysteine is toxic to the vascular endothelium but undergoes rapid
enzymatic metabolism so it is not normally present in the bloodstream.
However, a surprisingly large number of people have elevated blood
levels of homocysteine, in some cases because of a genetic inability to
metabolize homocysteine and in other cases because of a deficiency of
one or more vitamin cofactors required for its conversion. Such
individuals are at increased risk of peripheral vascular,
cardiovascular, and cerebrovascular disease.

Folic acid is thought to protect against heart disease because it
breaks down homocysteine and allows it to be cleared from the blood
stream. The University of Washington review referred to 11 studies of
folic acid's effects on homocysteine levels. Among these was the Tufts
research, which showed for the first time that inadequate intake of the
vitamin is the main determinant of the homocysteine-related increase in
the risk of carotid blockage.

The
nutrients mentioned above reflect the major nutritional supplements
that may help the condition. Please do remember however that
nutritional supplementation is an adjunct to medical treatment and in
no way replaces medical treatment.

High Triglycerides And Risk Of Heart Attack

High Triglycerides And Risk Of Heart Attack
Triglycerides are fats that come from the diet or are manufactured by the body. High levels of triglycerides contribute to atherosclerosis.
Very high levels of triglycerides can cause pancreatitis (inflammation
of the pancreas). A new study shows that the more triglycerides you
have in your blood, the greater your risk of having a heart attack. The
major triglyceride-containing lipoproteins are called
very-low-density-lipoproteins (VLDL), in contrast to the major cholesterol.html">cholesterol-containing
lipoprotein LDL. In contrast, HDL (good) cholesterol is believed to
carry cholesterol and other lipids from the arteries back to the liver.

High triglycerides are associated with a lot of other risk factors (low HDL, small dense LDL, obesity, Diabetes.html">diabetes),
so it could just be "guilt by association" and not a causal
relationship. We also have no evidence that lowering triglycerides
reduces risk of heart attack. Nevertheless, persons at risk should do
what they can to reduce their triglycerides: starting with reducing fat
and simple sugars (fruit juices are a common problem), increasing
exercise, and losing weight. If medication is needed, the most
effective are fibrates and niacin. A new fibrate called fenofibrate is
highly effective in reducing triglycerides. Some statins, such as
atorvastatin or Lipitor, also reduce triglycerides, especially at
higher doses.

The reasons why triglycerides increase a person's risk of heart
disease remain unclear. High triglycerides are associated with low
levels of HDL ("good") cholesterol and with increased amounts of small
dense LDL, the worst form of LDL.

Researchers found an association between fasting triglyceride levels
and heart attack risk, after adjusting for other risk factors,
including HDL levels. Patients with high triglyceride levels were more
likely to be males, diabetic, hypertensive, have a higher body mass
index, have a higher level of physical activity, and drink more alcohol.

The ratio of triglycerides to HDL was a strong predictor of heart
attack, suggesting a complex metabolic interaction between
triglycerides and other lipids. High triglyceride levels appears to
reflect a lower activity level of enzymes that break down fats in the
blood, resulting in higher levels of VLDL and lower HDL levels, which
are linked with increased heart attack risk.

Low-fat diets tend to elevate triglycerides and reduce the good HDL
cholesterol, particularly if carbohydrates are substituted for fat.
Only if these diets produce weight loss will the triglyceride levels
usually decline. Some nutritionists suggest a right-fat diet instead of
a low-fat diet; replacing saturated fat with monounsaturated fats can
reduce the bad LDL without depressing HDL and raising triglycerides.
Beer, wine, and hard liquor also elevate triglycerides; restriction of
alcohol intake to no more than five to six drinks per week.

Your liver can change any source of excess calories - carbohydrate,
fat or protein - into triglycerides. A triglyceride level of 250 mg/dl
(milligrams per deciliter of blood) or less is considered normal.
However, slight elevations of triglycerides, 250 to 500 mg/dl, often
accompany other unhealthy amounts of fat in the blood.