Hyperhomocysteinemia & Cardiovascular disease

Cardiovascular disease (CVD) is well-known to be the most common preventable cause of death globally. Its multifactorial aetiopathogenesis makes it difficult to manage. One of the emerging independent risk factors is the high level of homocysteine (hyperhomocysteinemia).

Homocysteine is an amino acid that being synthesized in your body from methionine. It is one of the building block of proteins. At a high level, homocysteine has been associated with several health conditions particularly cardiovascular diseases and impaired cognitive function.1 This has been demonstrated by several studies.1,2.,3

Hyperhomocysteinemia makes our blood vessels’ wall susceptible to injury leading to atherosclerosis, which is buildup of plaque. These plaques cause narrowing of the blood vessels.1 Depending on the location of the affected blood vessels, atherosclerosis may cause coronary heart disease or stroke. Hyperhomocysteinemia may also cause blood clots, thrombosis, that will lead to deep vein thrombosis or pulmonary embolism.1

In a healthy normal person, homocysteine level is maintained as it is being metabolized into other essential bioproducts for your body functions.1 These processes require cofactors including vitamin B9 (folate), B6 (pyridoxine) and B12 (cobalamin). Thus, if your homocysteine level is high, you may not be getting enough vitamin B9, B6, or B12 from your diet. Other causes of high level homocysteine are low thyroid hormone or diseases such as renal disease, diabetes and psoriasis.

Sources of folate includes leafy and green vegetables, cereals and beans while the sources for vitamin B6 cereals, potatoes, milk, poultry products and fish. For vitamin B12, food should be considered are dairy products, liver, beef and certain types of salmon. Supplements for these vitamins also may be considered to reach the required levels and have been shown to reduce homocysteine level.5


  1. Ganguly P, Alam SF. Nutr J. 2015; 14:6.
  2. Veeranna V, et al. J Am Coll Cardiol. 2011; 58(10):1025-33.
  3. Shenoy V, et al. Indian J Clin Biochem. 2014; 29(3):339-44.
  4. B vitamins and folic acid. Available at: https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-b/. Accessed 2 July 2020.
  5. den Heijer M, et al. Arterioscler Thromb Vasc Biol. 1998;18(3):356-61.

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