A Randomized Control Trial of the Effects of a Comprehensive Risk Reduction Nutrition Program on Plasma Homocysteine Levels in Hypertensives with Associated Cardiovascular Risk Factors.

Increased plasma homocysteine (HCY) is a risk factor for atherosclerotic cardiovascular disease. This association is amplified where hypertension (HTN) or hyperlipidemia (HLP) coexist. The impact of increasing dietary folate, B12, and B6 on HCY and the possible interaction of disease conditions in subjects at risk is not known. In 343 subjects with HTN, HLP, and/or NIDDM, we evaluated the short-term (10 wk) impact on HCY of two dietary regimens: A) a commercially prepared risk reduction nutrition program which provides all the recommended dietary allowances of all nutrients (folate 400 mcg/d, N=171), or B) a nutritionist-guided self-prepared diet meeting the macronutrient goals of a AHH step I/II diet (n=172). Plasma HCY (mean±SD) for subjects receiving diet A: Across HTN diagnostic groups the risk reduction diet (A) significantly (p < .005) lowered HCY compared to the self-selected diet (B). Subjects with all 3 risk factors though failed to demonstrate a benefit. The presence of more than one cardiovascular risk factor in HTN subjects is associated with no reduction in HCY when folate, B12, and B6 intake is increased.