Hyperhomocysteinemia increases the risk of developing cardiovascular, cerebrovascular and peripheral diseases independent of traditional risk factors eg, elevated serum cholesterol, hypertension and diabetes.
Vascular damage due to hyperhomocysteinemia includes endothelial cell injury increased platelets adhesiveness, enhanced low-density lipoprotein (LDL) deposits in the arterial wall and coagulation abnormalities.
Supplementation with folic acid alone or in combination with vitamins B6 and B12 has been shown to lower serum homocysteine levels. Folic acid acts as a co-substrate in the remethylation cycle, while vitamins B6 and B12 act as cofactor of various enzymes involved in homocysteine remethylation (methionine synthase) and transulfuration (cystamonin β-synthase and γ-cystathionase).
Vitamin E through its antioxidant effect, helps reduce LDL oxidation, which is one of the mechanism in the pathogenesis of atherosclerosis.