Should you take this new heart test on homocysteine levels to prevent strokes? Don’t let labs fool you, call your doc first

Homocysteine is a type of amino acid that the body makes naturally. “These are chemicals in the blood that help create proteins,” says Dr Patil. “Vitamin B12, Vitamin B6, and Vitamin B9 (folate) break down homocysteine to generate other chemicals that the body needs. High homocysteine levels may mean you have a vitamin deficiency. Without treatment, elevated homocysteine increases your risks for dementia, heart disease and stroke,” according to Cleveland Clinic, US. Usually, the normal levels in a healthy person are around five to 15 micromoles per litre. If you have more than 50 micromoles per litre, you are at risk of damaging the lining of arteries, blood clots or blood vessel blockages. All of these raise the risk of a heart attack.

An effective marker, do we need to test homocysteine levels?

A digital health platform’s analysis of its own lab data, based on 40,000 homocysteine tests done across the country, shows over 60 per cent of people in India have higher than normal levels of homocysteine in their bloodstream. The analysis indicates that 59 per cent of women were found with escalated levels of homocysteine. The age group of 18-30 years had the lowest incidence at 15.3 per cent while it was 30 per cent in the age bracket 31-40 years. This was followed by age groups of 41-50 years (about 19 per cent) – 51-60 years (about 17.3 per cent) and above 60 years (18.3 percent). “The test is an effective marker. But we recommend testing to screen heart disease in individuals only with a high cardiac risk,” says Dr Patil. Dr Sameer Gupta, an interventional cardiologist, agrees, saying, “Though a high level of homocysteine in the blood is a marker for increased risk of heart disease, there is not adequate clinical data to prove that interventions to lower homocysteine levels will reduce the risk of heart disease.”

When is a test recommended then?

Cardiovascular disease (CVD) is believed to account for one-third of all deaths worldwide. However, give a multiplicity of triggers, it is difficult to pinpoint one alone, says a study on “The Role of Homocysteine in the Development of Cardiovascular Disease (CVD)” in the journal ‘Nutrition.’ “Surely, there has been a better understanding over the years of this amino acid of interest and homocysteine is known as an independent risk factor for atherosclerosis. In this light, a test can be recommended if the patient has one or more conditions that can increase the risk of heart attack or stroke – such as high LDL (known as the bad cholesterol) or high blood pressure. Regular screening for early detection of diseases and prompt treatment are important but if the patient has high homocysteine levels, then the doctor can suggest taking Vitamin B12, B6 or folate supplements,” Dr Patil adds. “However, just increasing vitamin intake does not decrease the risk of heart disease as lifestyle corrections and monitoring markers through regular tests are necessary,” says Dr Gupta.