Abstract
Hundreds of studies have investigated the association between homocysteine and cardiovascular disease during the past several decades; results from randomised trials and observational studies have been discrepant, and the issue is not fully resolved. The common MTHFR 677C→T polymorphism increases homocysteine concentration, and mendelian randomisation studies of this polymorphism show a link with risk of stroke, supporting a causal relation. However, these studies have also been inconsistent. In The Lancet, Michael Holmes and colleagues1 summarise results from randomised trials of homocysteine reduction with folic acid supplementation (with or without additional B vitamins) to reduce stroke incidence.
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