The role of homocysteine in the clinical assessment of cardiovascular risk

Clinical and epidemiological studies suggest elevated levels of total plasma homocysteine (> 15 µmol/L) are associated with an increased risk of cardiovascular disease, independent of other known risk factors. This review outlines the causes of hyperhomocysteinaemia, current evidence of a positive association with cardiovascular disease, and how such findings may have important implications for future assessments of risk and nutritional recommendations, particularly for those with a previous or family history of cardiovascular disease.