Folic Acid Supplements Won't Lower Heart-Attack Risk

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But Alice H. Lichtenstein, director of the Cardiovascular Nutrition Lab at the USDA Human Nutrition Research Center at Tufts University, in Boston, countered that argument. She noted that even outwardly "healthy" Americans develop some level of atherosclerosis -- hardening of the arteries -- as they age, and so the findings would probably apply to the average consumer, as well.

Loscalzo thinks that the message from these studies may not be that lowering homocysteine doesn't prevent heart attacks, but rather that vitamin therapy is not the best way to lower homocysteine.

"These trials of vitamin therapy for high homocysteine have all been consistent in their message, namely, [that] combination vitamin therapies, which do lower homocysteine, have no effect on cardiovascular events, even though the homocysteine level is lowered," he said.

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Loscalzo said he believes the supplement treatment somehow counteracts the effect of lowering homocysteine. "Some of those adverse affects may have to do with the complex metabolism of the vitamins," he said. "These vitamins are important for cell growth. It may be that the doses used might have stimulated the growth of cell and atherosclerotic plaque."

According to Loscalzo, there's strong evidence that homocysteine does adversely affect blood vessels. So perhaps the answer lies in smaller doses of vitamins.

"These high doses of folic acid don't provide any benefit and shouldn't be used," Loscalzo said. "Lower doses are safe and may provide benefit, but we don't know that yet.

"It's not that homocysteine is no longer a bad actor," Loscalzo said. "It's that lowering it with this simple treatment isn't the answer."

Lichtenstein agreed that high doses of vitamins may not be as beneficial as some have thought.

"This is one of those cases where you see an association with reduced risk of heart disease with levels of vitamins that would normally be consumed, but when you go to considerably higher levels than people could consume from diet, we get disappointing results," she said.

More information

For more on homocysteine and heart disease, visit the American Heart Association (www.americanheart.org ).

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