Homocysteine Levels and Ischemic Stroke: A Systematic Review

The most common type of stroke is ischemic stroke. Given that death due to stroke is one of the three leading causes of death globally, it is essential to identify its risk factors, especially modifiable risk factors. Nowadays, High homocysteine is recognized as one of the risk factors for stroke. Our aim in this study was to investigate the association between homocysteine levels and ischemic stroke. We searched the keywords in Scopus, Web of Science, Google Scholar, PubMed, and Science Direct with a 15-year time limit. At first, 3884 studies were found, and after further investigation and based on inclusion and exclusion criteria, only nine studies were selected. Of the nine selected studies was a clinical trial and eight observational studies, and in total, there were 16227 participants in these studies. The prevalence of ischemic stroke was higher in people with high homocysteine levels than in people with normal homocysteine levels (14.1% vs. 9.8%). The prevalence was generally higher in men, but among people with high homocysteine levels, the prevalence of ischemic stroke was slightly higher in women than in men (12% vs. 11%), and also, in women and men, the prevalence of ischemic stroke was higher in people with high homocysteine levels than in people with normal levels. Based on selected studies, increased homocysteine levels in men and women increases the risk of ischemic stroke. Because homocysteine levels are a modifiable risk factor, diet and prevention of vitamin B12 decrease can help prevent an increased risk of ischemic stroke.