If I had to choose one word that might be the most important key to your cardiovascular health, that word would be "homocysteine."
Simply put: Reading cholesterol levels is not the most effective way to measure cardiovascular health. Your homocysteine level is a far more comprehensive indicator. Nevertheless, a new set of guidelines from the American Heart Association demonstrates how the homocysteine issue continues to be ignored by the mainstream.
If you're a long-time HSI member or e-Alert reader you already know that homocysteine is an amino acid that promotes the buildup of plaque on blood vessel walls, helping to increase coagulation. So it's no surprise that a high homocysteine level can significantly increase your risk of heart attack and stroke.
Fortunately your homocysteine level can be easily measured with a simple blood test. And fortunately you can take easy steps to lower your homocysteine level. But your doctor can't prescribe a drug to lower your homocysteine -- because there isn't one. Hence the silence. You can be sure that if Pfizer or Bristol-Myers Squibb or Merck made a prescription drug that could reduce it, homocysteine would be a household word.
The American Heart Association has just issued new guidelines for the primary prevention of cardiovascular disease and stroke, revising its previous set of guidelines issued in 1997. The updated guidelines make recommendations for risk factor screening (cholesterol profile, blood pressure, body mass index, etc.), global risk assessment (combining risk factors to determine risk of developing cardiovascular disease), and risk modifying interventions.
Don't get me wrong; these recommendations are all good. And the goals for risk modifying interventions - including zero exposure to tobacco smoke, blood pressure maintenance, achieving correct body weight, etc. - are goals everyone should aspire to. But one very important word is missing here.
Homocysteine.
In an e-Alert I sent you last year ("Beyond Cholesterol - Managing Your Risk for Heart Disease" 11/29/01) I explained that the mainstream medical establishment regards cholesterol as the primary indicator of heart disease because it's the indicator they can treat with prescription drugs. Homocysteine has been shown to be a more reliable indicator, but they don't have a pill to treat it. So with extreme tunnel vision, the mainstream devotes all of its attention to cholesterol, while ignoring information that suggests the validity of a more effective indicator.
Fortunately, homocysteine isn't ignored in research. We've several studies illustrating its importance. And this week I came across another report from Tulane University in which a population-based study was used to confirm that the dietary intake of folate may significantly reduce the risk of stroke and cardiovascular disease (CVD). And how is that accomplished? By lowering homocysteine.
The Tulane Team examined 9,764 U.S. men and women aged 25 to 74 years using the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study (NHEFS). All subjects were established to be free of cardiovascular disease at the beginning of the study, and then dietary intake of folate was assessed using dietary recall.
Over a follow-up period of 19 years, 926 stroke events and 3,758 CVD events were documented. After adjusting for variables such as diabetes, tobacco use, blood pressure, age and physical activity, the researchers concluded that subjects with a higher dietary intake of folate substantially decreased their risk of stroke and CVD.
Homocysteine metabolism depends on nutrients such as folate, vitamin B6 and B12. That's why your homocysteine level drops when you increase your natural intake of folate. However, it doesn't always happen quite that easily. Most people who increase their dietary folate intake - by eating asparagus, lentils, chickpeas, most varieties of beans, and especially spinach and other leafy green vegetables - respond with a lower homocysteine reading. But if the diet doesn't do the trick, then vitamin supplements often will. Folate (or folic acid) and vitamins B6 and B12 can be found in any health food store or drug store.
Getting a reading of your homosycteine level is an important first step to controlling it. Most commercial laboratories (and the doctors who use them) consider homocysteine levels between 5 and 15 micromoles per liter of blood to be in the "normal" range. However, what is "normal" and what is "safe" are two entirely different things. Studies have found that your risk of heart attack and coronary artery disease (CAD) begin to increase at levels of around 6.5. A homocysteine level of 10 roughly doubles your risk for CAD, and a reading of 15 (the high end of "normal") increases your risk four-fold. Readings over 15 are considered extremely dangerous.
So the next time your doctor takes a blood sample, ask about your homocysteine level and discuss this important issue. And if you know someone who has concerns about preventing stroke and heart attack - which should be just about everyone! - please help me on this mission to get the word out. Share this e-Alert with friends and let them know that lowering homocysteine, more than lowering cholesterol, can help lead to a long, heart-healthy life.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
Sources:
"Dietary Intake of Folate and Risk of Stroke in US Men and Women" Stroke, 2002;33:1183-1189
"Heart Association Updates Preventive Guidelines" Consumer Health Digest, 7/23/02 |
