Q: Is homocysteine a risk factor for CVD?

A:The available data suggests that homocysteine really is a risk factor for CVD and not hype. India is facing an epidemic of cardiovascular disease. Coronary artery disease (CAD) occurs much more prematurely in our country and under 40 years. Triple vessel disease is 2.5 times more common and carries highest morbidity and mortality. This high rate of CAD, cannot be explained by the presence of conventional risk factors such as hypertension, smoking, diabetes and hypercholesterolemia. It is in this context that homocysteine plays a role in being an early reversible risk factor for atherosclerosis. In the era of evidence-based medicine, with the available evidence it is getting increasingly proved that Coronary Artery Disease is lined to hyperhomocysteinemia (HCA) and as its risk factor. The strongest epidemiological for an association between hyperhomocysteinemia and vascular risk comes from large prospective cohort studies.