Novel risk factors for stroke: homocysteine, inflammation, and infection.

Recent studies have suggested that the risk of stroke may be increased in patients with several novel predisposing conditions. Although some controversy remains, the evidence supporting an association between moderately elevated levels of homocysteine and stroke is fairly strong. Studies are in progress to determine whether treatment with folate in combination with vitamins B(6) and B(12) will reduce the risk of stroke in patients with increased serum homocysteine. Evidence is also being gathered that suggests that patients with chronic inflammation, as well as those with chronic or acute infection, are at elevated stroke risk. The therapeutic implications of these latter associations have not yet been explored.