"Breast cancer claims 5 percent of American women; heart disease claims 36 percent. Heart disease, previously thought to be a "man-only" illness, is the number-one killer of women in the United States." Morris, Notelovitz, M.D., Ph.D.

The fact is that the number one cause of death in the United States is heart disease, in men and women. The third leading cause of death in the United States is stroke.

Some well-known key risk factors that lead to heart disease and stroke are diabetes mellitus, smoking, obesity, and elevated blood cholesterol, high blood pressure and family history of heart disease or stroke. However, most people are unaware that an elevated blood homocysteine level puts us at risk for heart disease and stroke as well.

Homocysteine is an amino acid that occurs naturally in the body, but at elevated levels, it is associated with greater incidence of heart disease and stroke. High homocysteine levels may also be associated with incidence of Alzheimer's disease, chronic fatigue syndrome and rheumatoid arthritis.

At higher than normal levels, homocysteine damages the lining of the arteries. Lowering homocysteine levels is a fairly straightforward matter, except in cases of homocystinuria, a rare genetic disorder characterized by extremely high homocysteine levels that are difficult to regulate. You can take these practical steps toward keeping your homocysteine levels within normal range:

• Increase your dietary intake of folic acid, Vitamin B6 and B12. Folic acid, in concert with Vitamin B6 and B12, work to break down homocysteine concentrations in plasma.
• Fresh is best. Prolonged heating, boiling or microwaving food may reduce or destroy the folic acid contained in food.
• As we get older, it's harder for the body to absorb B12 contained in food. People over 50 are advised to meet their RDA with a supplement containing B12.
• Take a good multi-vitamin daily to cover your bases, just in case your diet doesn't provide all the folic acid, B6 and B12 you need. Don't load up on more supplements than necessary. Be aware that taking too much folic acid can mask B12 deficiency.
• Stop smoking. Smoking raises homocysteine levels.

Women who are taking HT appear to have lower homocysteine levels than women who do not take hormones. "It may be that HRT provides additional cardiac protection by lowering homocysteine," says Dr. Michele Hamilton, M.D., assistant clinical professor of cardiology at UCLA and director of the UCLA Heart Failure program. "A woman should still make a decision about HT in terms of the whole picture of her health." She adds that women on HT should still take a multi-vitamin to ensure that they are getting adequate folic acid, B6 and B12.

Although, homocysteine testing is not yet a routine health screening, homocysteine levels are evaluated with a blood test through most large diagnostic laboratories. There is virtually no downside to the test, either you have high homocysteine or you don?'. The assay puts you in a position to know if you do, and to do something about it.

There is a lot of new information out there, but the key is to keep an open mind while doing your research so that you can make an informed decision about your health and well-being. Women's Health America's multivitamin/mineral supplements ProCycle^® PMS and ProCycle^® Gold contain folic acid, B6, B12 and the antioxidant vitamin E, which may help in lowering homocysteine levels and promoting cardiovascular health.