CLEVELAND, Nov. 14, 1995 -- People with low levels of the vitamin B6 have a greater chance of developing heart disease, a newly published study by a team of cardiologists and cell biologists at The Cleveland Clinic Foundation concludes.

Several recent studies have shown that high levels of homocysteine, an amino acid in the blood, is associated with coronary artery disease, often leading to heart attacks and strokes. Previous studies have focused on deficiency of the vitamin folic acid and its association with homocysteine. But the Clinic's study, published this week in "Circulation" magazine, indicates that the link between homocysteine and vitamin B6 is more profound.

"We have shown it is not just folic acid, but it's a vitamin B6 deficiency as well," said Killian Robinson, M.D., a cardiologist at The Cleveland Clinic and principal investigator for the study. "It seems to be a very prevalent problem."

The study compared 304 patients (201 men and 103 women) being treated for coronary artery disease. The study found that vitamin B6 deficiency is as much a risk factor for coronary artery disease as smoking and high cholesterol. Deficiencies of folic acid and B12, which have been linked to homocysteine levels and vascular disease, were shown not to be as significant risk factors as B6 in coronary artery disease.

Dr. Robinson said a large clinical trial is needed to determine how treatments involving B6 may affect the mortality rate of patients with coronary artery disease. "We have to determine if this is reversible. We presume that it is," he said.

Most people don't know if they have a vitamin B6 deficiency. Multivitamins, Dr. Robinson said, are good for daily nutritional needs, but not to overcome a deficiency. Vitamin B6 supplements should be used only on a doctor's recommendation because an overdose is possible.

The Cleveland Clinic study also determined that women and the elderly need to be concerned about their homocysteine levels and intake of vitamins. Previous studies generally have focused only on how homocysteine is associated with premature coronary heart disease in younger men.

"When determining a person's risk of developing coronary artery disease, it's becoming clear that doctors need to do more than monitor a patient's cholesterol levels and blood pressure. Homocysteine and vitamin deficiencies need to be considered as well," Dr. Robinson said.

Celebrating 75 years of world-class care, The Cleveland Clinic Foundation continues to advance the frontiers of medicine by providing state-of-the-art care in a multispecialty academic medical center model. Since its founding in 1921, clinical and hospital care have been integrated with research and education in a private, non-profit group practice which has distinguished The Cleveland Clinic in American medicine. Today at The Cleveland Clinic and Cleveland Clinic Florida, nearly 600 full-time, salaried physicians represent more than 100 medical specialties and subspecialties. Every year, The Cleveland Clinic and Cleveland Clinic Florida provide for more than 833,000 outpatient visits and 39,000 hospital admissions from throughout the United States and more than 80 countries.

CONTACT: Rob Whitehouse of The Cleveland Clinic Foundation, 216-444-8927, or E-mail: whitehr@cesmtp.ccf.org/