Homocysteine Lowering in Stable Chronic Vascular Disease: The Heart Outcomes Prevention Evaluation (HOPE)-2 Trial
Mar 13, 2006 - 8:37:00 PM
, Reviewed by: Sanjukta Acharya
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"This is the largest trial worldwide completed to date to measure clinical events associated with a reduction of homocysteine levels following treatment with folate and other B vitamins."
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By American College of Cardiology,
[RxPG] High blood levels of the amino acid homocysteine have been linked to an increased risk of cardiovascular disease. Treatment with folic acid, vitamin B6, and vitamin B12 can reduce homocysteine levels by 25 percent to 30 percent, but the clinical benefits of vitamin supplements have been uncertain. The HOPE-2 study has taken steps to determine whether reducing homocysteine levels also reduces the long-term risk of heart attack, stroke or death.
"The idea is very attractive, because homocysteine levels can be easily reduced in most people with inexpensive therapy," said Eva M. Lonn, M.D., M.S.c., F.A.C.C., a professor of medicine and cardiology at McMaster University, Hamilton, Ontario, Canada. "This is the largest trial worldwide completed to date to measure clinical events associated with a reduction of homocysteine levels following treatment with folate and other B vitamins."
Homocysteine is a normal byproduct of the breakdown of methionine, an essential amino acid. Folic acid, vitamin B6, and vitamin B12 are involved in several steps of the complex homocysteine metabolic pathway, ultimately enhancing homocysteine breakdown and excretion.
The HOPE-2 trial involved an international team of researchers from 145 medical centers in 13 countries in North America, South America, and Europe. Investigators enrolled 5,522 patients with established cardiovascular disease or diabetes, randomly assigning them to daily vitamin intake with folic acid, 2.5 mg; vitamin B6, 50 mg; and vitamin B12, 1 mg, or placebo. After two years of vitamin supplements, homocysteine levels were reduced by about 25 percent.
Publication:
Dr. Lonn will report on the clinical results of a follow-up averaging five years at a Late Breaking Clinical Trial session on Monday, March 13, at 2 p.m.
On the web:
www.acc.org 
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Additional information about the news article
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The American College of Cardiology (www.acc.org) represents the majority of board certified cardiovascular physicians in the United States. Its mission is to advocate for quality cardiovascular care through education, research, promotion, development and application of standards and guidelines- and to influence health care policy. ACC.06 and the ACC inaugural i2 Summit, the first-ever meeting for interventional cardiologists, will bring together more than 30,000 cardiologists and cardiovascular specialists to share the newest discoveries in treatment and prevention, while helping the ACC achieve its mission to address and improve issues in cardiovascular medicine
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