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Background

Cardiovascular disease, which includes coronary artery disease, stroke and peripheral vascular disease, is a leading cause of death worldwide. Homocysteine is an amino acid with biological functions in methionine metabolism. A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level. The impact of homocysteine‐lowering interventions, given to patients in the form of vitamins B6, B9 or B12 supplements, on cardiovascular events has been investigated. This is an update of a review previously published in 2009, 2013, and 2015.

Objectives

To determine whether homocysteine‐lowering interventions, provided to patients with and without pre‐existing cardiovascular disease are effective in preventing cardiovascular events, as well as reducing all‐cause mortality, and to evaluate their safety.