Omland et al1 validate once more the 30-year-old theory regarding the direct association between serum homocysteine levels and cardiovascular diseases and death. The authors suggest that there is merit in "stratifying patients into groups that are more or less likely to benefit from homocysteine-lowering therapy" based on serum homocysteine levels.
Such "therapy" effectively consists of recommending a multivitamin-mineral supplement with somewhat higher-than-daily-value amounts of several of the B vitamins (pyridoxine hydrochloride [B6], cyanocobalamin [B12], and folic acid). Therapy with, for example, 25 mg of B6, 100 µg of B12, and 400 µg of folic acid is simply obtained in a high "potency" (no-iron) multivitamin that can be bought in the United States for as little as $0.10 a day. Such supplements usually also contain several other nutrients important in homocysteine metabolism (eg, zinc, which is a factor in the betaine-homocysteine–lowering pathway).