Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins: The atherosclerosis risk in communities (ARIC) study

Aaron R. Folsom, F. Javier Nieto, Paul G. McGovern, Michael Y. Tsai, M. René Malinow, John H. Eckfeldt, David Hess, C. E. Davis

    Research output: Contribution to journalArticle

    565 Citations (Scopus)

    Abstract

    Background - Elevated plasma total homocysteine (tHcy), low B-vitamin intake, and genetic polymorphisms related to tHcy metabolism may play roles in coronary heart disease (CHD). More prospective studies are needed. Methods and Results - We used a prospective case-cohort design to determine whether tHcy-related factors are associated with incidence of CHD over an average of 3.3 years of follow-up in a biracial sample of middle-aged men and women. Age-, race-, and field center-adjusted CHD incidence was associated positively (P677T mutation of the methylenetetrahydrofolate reductase gene or with 3 mutations of the cystathionine β-synthase gene. Conclusions - Our prospective findings add uncertainty to conclusions derived mostly from cross-sectional studies that tHcy is a major, independent, causative risk factor for CHD. Our findings point more strongly to the possibility that vitamin B6 offers independent protection. Randomized trials, some of which are under way, are needed to better clarify the interrelationships of tHcy, B vitamins, and cardiovascular disease.

    Original languageEnglish (US)
    Pages (from-to)204-210
    Number of pages7
    JournalCirculation
    Volume98
    Issue number3
    StatePublished - Jul 21 1998

    Fingerprint

    Vitamin B Complex
    Homocysteine
    Genetic Polymorphisms
    Coronary Disease
    Fasting
    Atherosclerosis
    Prospective Studies
    Incidence
    Cystathionine
    Methylenetetrahydrofolate Reductase (NADPH2)
    Mutation
    Vitamin B 6
    Genes
    Uncertainty
    Cardiovascular Diseases
    Cross-Sectional Studies

    Keywords

    • Coronary disease
    • Homocysteine
    • Polymorphism (genetics)
    • Vitamins

    ASJC Scopus subject areas

    • Physiology
    • Cardiology and Cardiovascular Medicine

    Cite this

    Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins : The atherosclerosis risk in communities (ARIC) study. / Folsom, Aaron R.; Nieto, F. Javier; McGovern, Paul G.; Tsai, Michael Y.; Malinow, M. René; Eckfeldt, John H.; Hess, David; Davis, C. E.

    In: Circulation, Vol. 98, No. 3, 21.07.1998, p. 204-210.

    Research output: Contribution to journalArticle

    Folsom, Aaron R. ; Nieto, F. Javier ; McGovern, Paul G. ; Tsai, Michael Y. ; Malinow, M. René ; Eckfeldt, John H. ; Hess, David ; Davis, C. E. / Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins : The atherosclerosis risk in communities (ARIC) study. In: Circulation. 1998 ; Vol. 98, No. 3. pp. 204-210.
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    AU - McGovern, Paul G.

    AU - Tsai, Michael Y.

    AU - Malinow, M. René

    AU - Eckfeldt, John H.

    AU - Hess, David

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    AB - Background - Elevated plasma total homocysteine (tHcy), low B-vitamin intake, and genetic polymorphisms related to tHcy metabolism may play roles in coronary heart disease (CHD). More prospective studies are needed. Methods and Results - We used a prospective case-cohort design to determine whether tHcy-related factors are associated with incidence of CHD over an average of 3.3 years of follow-up in a biracial sample of middle-aged men and women. Age-, race-, and field center-adjusted CHD incidence was associated positively (P677T mutation of the methylenetetrahydrofolate reductase gene or with 3 mutations of the cystathionine β-synthase gene. Conclusions - Our prospective findings add uncertainty to conclusions derived mostly from cross-sectional studies that tHcy is a major, independent, causative risk factor for CHD. Our findings point more strongly to the possibility that vitamin B6 offers independent protection. Randomized trials, some of which are under way, are needed to better clarify the interrelationships of tHcy, B vitamins, and cardiovascular disease.

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