The research paper discusses the action of a chemical compound called homocysteine. This compound in many medical cases is blamed as the origin of a major and silent killer disease that disables more people prematurely than any other disease or medical condition. The paper tries to further define and analyze what is homocystene, how it is related to heart diseases and heart attacks. It furthers seeks to clarify the possible dietary and lifestyle recommendations in the prevention of heart attack and reduction of homocystein in the serum.
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Homocysteine according to Mc Cully (5) is a chemical compound that has traces of amino acids (ethylene) and methylene and exists in mostly the blood serum. The presence of homocystein in the blood serum has some negative effects in the arteries. It is the major contributor to peripheral heart diseases that would lead to stroke and heart attack.
The presence of homocysteine causes an effect called the arteriosclerosis. This is the hardening and the stiffening of all the arteries in the body but mostly the arteries leading to the neck, legs and heart. This mostly occurs because of the lump deposition of fats and cholesterol in the arterial walls. It also noted that the deposition of the fats and cholesterols becomes clogged at some points of the arteries hence reducing the arterial sizes and causing damages to the inner linings of the arteries.
The reduced and damaged arterial size facilitates the formation of the blood clots and these leads to the inefficient supply of blood to the major body organs. This condition can also lead to adverse conditions as heart attacks, strokes and amputated legs (Mc Cully 292).
Chhajer (89) defines heart attack or myocardial infraction as a condition of complete obstruction of blockages of blood supply to some parts of the heart muscles. The blockages develop progressively in people who have problem like high fats, high cholesterol, trigly cerides, high blood pressure, diabetes and sedentary lifestyle with high fatty foods. Chhajer (221) further explains that this condition completely deprives the heart muscles of theirblood and oxygen supply, which leads to its death. The deprivation of the heart muscles leads to a sudden rupture of the developing blood barriers. A thin membrane called the intimal membrane also covers the thin blood barriers.
Page 2 The Mechanism of Action of Homocysteine in relation to heart attacks Essay
This membrane stretches increasingly as more fatty deposits occur, but ifthe fatty deposits occur beneath it, it will continue stretching until it will reach it’s elastic limit and break off. The breaking off- will lead to the formation of a thrombus inside the tube, which will close the lumen completely. It is here that the process of heart attack becomes complete. This is so because the area of the heart muscle that gets the blood from the arteries dies because of artery blockage( Chhajer 221).
Most of the severe heart attacks occur in the early morning, after taking a heavy meal with high fatty contents and in the events of hunger or during excessive sorrow. This occurs mostly because after such events the process of angiography’s and angioplasty occurs, which triggers the inflation of the balloons that totally blocks the lumen of the coronary artery, this has devastating effect. (Verhoef etal 991).
In some cases heart attacks can be very silent which can never be detected easily. The silent attacks victims mostly have been proved to diabetics; this is so because most of their attacks affect the nerves and not the arteries as experienced in other cases. The silent attacks are manifested in these forms; sudden loss of consciousness, state of total disorder, intense weakness and irregular heartbeat and unexplained decreases in the blood pressure.( Watson and victor 203)
Medical doctors and physicians advise that it is very important for individuals to monitor their homocystein levels. This is because elevated levels of it in the blood (>10 micro moles/liter) are the major courses of autheroclerosis- a condition shown above as the hardening and the narrowing of the arteries. (Watson and Victor 203) .These two conditions increase the risks of heart attack in individuals, increase the risk of strokes and may also increase the risk of attack of a Alzheimer’s disease. The monitoring of homocystein level in the body of children is very important for children born with a genetic disorder known as homocystinuria (increases level of homocysteine) in the blood and is more vulnerable to heart attacks. Sometimes they die early with advanced atherosclerosis in their arteries.
Elevated levels of homocysteine in the blood are believed to cause the narrowing and hardening of the arteries. It is the narrowing that leads to diminished blood flow through the affected arteries. Elevated levels in the blood also increase the tendency of excessive blood clotting inside the arteries. This diminishes the flow of blood, and the resultant lack of blood supply to the heart muscles causes heart attacks, while lack of blood supply to the brain cause strokes and maybe Azhamer. MC Cully (78) . According to MC Cully, Children with high amount of homocysteine are prone to mild mental retardation Homocystinuria is also characterized in kids by; very tall statures, others also show very flushed complexions, light colored hair and another worse one is the dislocation of the eye lenses (MC Cully79).
The tall statue as discussed by MC Cully is a rapid growth in childhood that is producing long legs and long arms. Most of the kids with this kind of disease die of blood clots that develop in the arteries to the brains and to their hearts or kidney. It happens more frequently because the arteries are abnormal, with hardening and loss of elasticity’s at the arteries walls (Mc Cully 83).
The main cause of the elevated Homocysteine levels in the blood systems is a chemical transformation which reacts on it and transforms in to methionine and cystein, this is done with the help of folic acid, Vitamin B12 and Vitamin B6. This explains the elevated level as Mc Cully further illustrates that the reactions results to the reduction in the amount of these chemical substances (folic acid, Vitamin B 12 and Vitamin B6) in the body. Therefore, insufficient amounts of these vitamins in the body can hamper the natural breakdown of homocysteine. This cause homocysteine to accumulate in the blood, Mc Cully (85)
The main factors that increase and speed up heart attack is heavy smoking of cigarettes, blood pressure, diabetes, a sedentary lifestyle, genetic (family) background with a history of heart diseases, the gender (male), a progressive age and obesity (especially excess abdominal fat). Although it can also be sped up by lack of physical activity and abnormal blood cholesterol level. (MC Cully 87). He gives a comment that factors as age, gender and family background cannot be altered but peoples must work on the other factors.
The action of homocystein as a contributor to the heart disease cannot be understated, as indicated by Verhoef etal(989), an elevated blood level of homocysteine has been linked to the increased level of premature coronary artery and heart diseases, stroke and thromboembolism (venous blood clots). This was even detected among the people who have normal cholesterol levels in their arterial systems. It has also been noted by Verhoef etal (990) that, abnormal homocysteine levels in the blood contribute to arteriosclerosis in many ways.
This was confirmed by research in which the researchers detected a linear relationship between homocysteine levels in the blood and severity of the coronary blockages. It made the researchers to conclude that homocystein concentration in the blood contribute to the heart disease in different ways; by directly damaging the linings of the cells that line the internal walls of the arteries, secondly it interferes with the clotting factors hence interfering with the whole process, the third way by which it contributes to the risk of heart attacks is that it catalyzes the reaction which oxidizes the low-density lipoproteins (Bolander 25).
Bolander later on clarified that the history of connection between the homocysteine and cardiovascular disease was suspected about 1982. This is when it was closely observed that people with a very rare condition called homocystinuria are highly prone to develop cardiovascular complications in their young adulthood ages. This is so because in this state there is an enzyme shortage that propels homocysteine to build up in the blood and to be excreted in the urine
There were more studies monitored by Schnyder etal (990), which came out with three concrete conclusions. These are; post menopausal women with eminent homocysteine levels have an upper frequency of coronary heart disease, the second study concluded that homocysteine levels were much higher in people who developed vein clots than in similar people who did not develop the vein clots and lastly it found out that elevated increased risk of stroke are associated with elevated levels of homocysteine in the people who already have coronary heart disease.
In the transmission of the heart disease it is indicated that homocystinuria is mostly transmitted by recessive gene. This gene becomes dangerous and gives the offspring a very high level of plasma homocysteine if both the parents transmit it. It is further clarifies that the gene does not affect those who receive defective one from only one parent but end up developing a mildly elevated plasma level of homocysteine.
Mc Cully further indicates that abnormal increase in the level of homocysteine occurs regularly in the people whose diets includes little or no folic acids, vitamin B6 Or Vitamin B12. Although limited amounts of these elements can cause the increase in the level of homocysteine, any of them when used properly (in good quantity and time) can lower the plasma levels in the homocystein, the most recommended one for this is the dietary intake of folic acid by most people. (Mc Cully 29)
Dietary and lifestyle recommendation:
The prevention of this problem is better than the curative measures which may not be possible, and therefore it is advisable that those who have higher plasma levels in the homocystein can reduce it by the taking fresh fruits and vegetables (Chhajer 125). When this is not effective vitamin B6 and B 12 must be added to cause of the therapy, and this is advisable to be continued forever. More research by Chhajer indicates that the risk of heart attack was very minimal among the people who used multivitamins or had the highest intake of folic acid and B6 from dietary sources.
This research supports the finding that elevated homocysteine levels are associated with a higher incidence of heart disease. It is also a common advice from some doctors that patience known to have atherosclerosis gets a recommendation of B-Vitamin supplements even without any medical test. This helps to determine weather there is an increase in their homocysteine levels. This, doctors support by reasoning that since using other supplements of B-vitamin causes no harm while increase in the homocystein levels is a factor of grave concern, patience should not bother so much. The doctors further clarifies that patience should find out weather the level of homocystein has changed so that the B-Vitamin supplement can be adjusted for good health. (Watson and Victor 293).
There are also other proofs that lowering the concentration of serum in homocystein is a sure way of reducing the risk of adverse cardiovascular occurrences among the patience with homocystinuria. Although this is so the same studies have not proved that reducing homocysteine levels in our body would reduce the incidence of heart attacks or other incidences of strokes among individuals who show meekly increase homocystein levels (Watson and victor78).
The treatment of this condition should start by the initial screening of an individual for the elevated homocysteine levels. This is only advisable for the people who have experienced coronary artery disease. Mostly the disease is as a form of the family hereditary who have that history for the premature atheroscleroticn diseases (Watson and Victor 49). The doctors have shown that the effects of the supplementation are usually evidenced within duration of four weeks. They further shows that the body adjusts its reliance on one or the other and that supplementing with other B-Vitamins is a more and sure way of improving homocysteine levels. (Watson and Victor50). Doctors have concluded another sure way that, a combination of folic acid, vitamin B12, and vitamin B6 or a placebo can actually reduce the incidence of heart attacks and deaths. Since folic acid is nontoxic, they say it seems prudent to cure elevated homocysteine levels base. Although they give a caution that a well-informed physician should closely supervise the whole process.
Heart attacks can be related to various causes, others that can be controlled while others are beyond our normal control, one such factor which can be controlled includes the homocysteine (tHcy) concentration, which is influenced by folate and vitamin B-12 status, is a suspected cause of cardiovascular event. The elevated homocysteine levels can be caused by a lot of vitamin B12 deficiency due to impaired absorption of B12 caused by gastric atrophy (damage to the lining of the stomach) (Watson and Victor59).
Intake of folic acid supplements can correct anemia (which can serve as a warning sign before nerve damage develops), but they do not prevent the damage. Because of this reason, people over who take folic acid supplements should also take at least some vitamin B12 per day; this will enable adequate amounts of folic acid to be absorbed. Doctors also advice that to prevent gastric atrophy in people above 50 , they should take vitamin B12 supplements as argued by Watson and Victor.
Bolander Christina. Focus on Homocysteine and Vitamins: Involved Metabolism. London:
Springer publishers, 2001
Chhajer Bilma. 201 Tips for Diabetes Patients. Diamond pocket Publishers, London 2001.
Mc Cully Kilmer. The homocystein revolution. New York: Mc Graw-Hill, 1999.
Schnyder Gerhard etal. Homocystein lowering therapy with folic acid, Vitamin B12,and Vitamin
B 6 on clinical outcome after percutaneous coronary intervention. JAMA, 288;973-979,2002
Verhoef Petra etal. Plasma total homocystein, B vitamins and risk of coronar atherosclerosis
Arteriosclerosis, Thrombosis and Vascular Biology 17:989-995, 1997.
Watson Ronald Ross and Victor R. Preedy. Nutrition and Heart Disease: Causation and Prevention.
New York: CRC publishers, 2003.
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