Hyperhomocysteinemia: its impact on cardiovascular disease and atherosclerosis

Abstract

Hyperhomocysteinemia (HHcy) was found to be a risk factor for cardiovascular disorders and many other diseases. HHcy occurs when homocysteine (Hcy) exceeds 15 μmol/L. The prevalence of HHcy ranges from 5 – 10% in the general adult population. HHcy can cause atherosclerosis and heart dysfunction through oxidative stress, inflammation, endothelial interaction with leukocytes, coagulation, endothelial fibrosis, SMCs proliferation, apoptosis, lipids dysregulation, epigenetic modifications and modifications of electrical conduction in the heart. Some of the drugs that have been studied have been shown to be effective in reducing the level of HHcy. Conclusion: High Hcy level can be a strong cause in several disorders including cardiovascular diseases. So, serious effort should be made to avoid and treat HHcy. All evidence suggests that Hcy is causally connected to atherosclerosis by many mechanisms. But future studies should concentrate on the molecular pathways of HHcy in cardiac dysfunction, and the effects of Hcy-lowering medications on cardiac dysfunction.