Pathophysiology and clinical importance of hyperhomocysteinemia: clinical intervention studies.

Hyperhomocysteinemia is a cardiovascular disease risk factor in the general population and in patients with renal failure. This article summarizes the results of recent total homocysteine-lowering intervention studies in individuals without renal failure and in patients with renal failure. Although almost all of the published studies mainly focused on the total homocysteine-lowering effect and not on cardiovascular disease outcomes of folic acid and vitamin therapy, recent work has gained important insights into this area of developing concern.