ABSTRACT
The clinical observation linking serum homocysteine with cardiovascular disease (CVD) was made over 35 years ago1 and since then much evidence has accumulated on the subject. However, opinion on whether homocysteine causes CVD remains divided.2 Resolving the uncertainty is important as serum homocysteine levels can be lowered by taking additional folic acid, raising the prospect of a simple means of prevention.3 This chapter examines the evidence for a causal relation between homocysteine and coronary heart disease (CHD) and considers the implications for prevention.
