title: Lowering homocysteine levels may prevent cardiovascular impairments? Possible therapeutic behaviors.
abstract: Homocysteine (Hcy) is metabolized through two pathways, requiring folates and B6-12 vitamins as cofactors. Increased Hcy concentration is responsible for early atherosclerosis with possible acute cardiovascular events. Ample evidence has demonstrated that Hcy lowering with folic acid and B vitamin supplementation, even if reduces Hcy serum levels, is unable to lower cardiovascular risk. On the contrary, omega-3 fatty acids and some nutraceuticals, such as N-acetyl cysteine, taurine, or S-adenosyl-methionine, reduce both Hcy serum concentration and cardiovascular risk. Instead, antiplatelet drugs, such as aspirin and clopidogrel or ticlopidine and statins only antagonize vascular derangements. Finally, metformin, some lipid-lowering drugs, and some diuretics should be avoided because they can increase Hcy levels.
authors.forename: Federico
authors.initials: F
authors.lastname: Cacciapuoti
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage*; D001241:Aspirin / Q000009:adverse effects; D001808:Blood Vessels / Q000187:drug effects / Q000473:pathology; D002318:Cardiovascular Diseases / Q000097:blood / Q000473:pathology / Q000517:prevention & control*; D000077144:Clopidogrel; D004232:Diuretics / Q000009:adverse effects; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005492:Folic Acid / Q000008:administration & dosage; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D007004:Hypoglycemic Agents / Q000009:adverse effects; D008687:Metformin / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D012436:S-Adenosylmethionine / Q000008:administration & dosage*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives; D014805:Vitamin B 12 / Q000008:administration & dosage; D025101:Vitamin B 6 / Q000008:administration & dosage
chemical_list: D004232:Diuretics; D015525:Fatty Acids, Omega-3; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D010975:Platelet Aggregation Inhibitors; D006710:Homocysteine; D012436:S-Adenosylmethionine; D025101:Vitamin B 6; D008687:Metformin; D005492:Folic Acid; D000077144:Clopidogrel; D013988:Ticlopidine; D014805:Vitamin B 12; D001241:Aspirin; D000111:Acetylcysteine