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Preventing adverse cardiovascular outcomes.

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1192 Canadian Family Physician • Le Médecin de famille canadien dVOL 5: SEPTEMBER • SEPTEMBRE 2005

Letters Correspondance

Preventing adverse

cardiovascular outcomes

Y

our recent helpful review of vitamins1 might leave some readers with the impression that sup- plementing with vitamins in order to lower elevated plasma homocysteine levels will protect against heart disease. A well-done study showed that nor- malizing elevated plasma homocysteine does not prevent adverse cardiovascular outcomes.2 It seems to me that a patient with high homocysteine levels would benefit from intensive cardiovascular risk fac- tor lowering by lifestyle changes, statins, and what- ever else is required to achieve the lipid targets for patients at high risk of cardiovascular illness.

—E.H. Krikke, MD, FCFP Edmonton, Alta by e-mail

References

1. Ryan-Harshman M, Aldoori W. Health benefits of selected vitamins. Can Fam Physician 2005;51:965-8.

2. Toole JF, Malinow MR, Chambless LE, Spence JD, Pettigrew LC, Howard VJ, et al.

Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myo- cardial infarction and death: the Vitamin Intervention for Stroke Prevention (VISP) ran- domized controlled trial. JAMA 2004;291:565-75.

...

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