Serum total homocysteine concentration is related to self-reported heart attack or stroke history among men and women in the NHANES III

High circulating total homocysteine (tHcy) concentration, which is influenc ed by folate and vitamin B-12 status, is a suspected cause of cardiovascula r events. This relation has been investigated in both case-control and pros pective studies but has not been evaluated for different sex x age subgroup s of the general U.S. population. We used data on adult (i.e., aged greater than or equal to 40 y) male (n = 1097) and female (n = 1107) participants in the third National Health end Nutrition Examination Survey, excluding di abetics and those supplemented with estrogen, vitamins or minerals, to eval uate the association between serum tHcy concentration and self-report of he art attack or stroke, After adjustment for age, race-ethnicity, smoking, bl ood pressure, blood pressure medication, body mass index and serum concentr ations of creatinine and cholesterol, past events were reported 2.4 (95% co nfidence interval 1.0-5.5) times as often by men with tHcy concentration of >12 mu mol/L as by men with lower values. The odds ratio for women was 2.6 (95% confidence interval 1.1-6.6) after adjustment for the same factors pl us menopausal status. A stronger relation in men aged less than or equal to 60 y compared with older men may help reconcile conflicting results of ear lier studies.