Inclusion Criteria:

- Women and men 55 years of age or over with established CVD and at high risk for
future fatal and nonfatal CV events, defined as:

1. Documented coronary artery disease (CAD);

2. Documented peripheral vascular disease (PVD);

3. Documented cerebrovascular disease;

4. Diabetes with one of the following; additional cardiovascular risk factors:

i) hypertension (BP >160 mmHg systolic or >90 mmHg diastolic or on treatment); ii)
total cholesterol >5.2 mmol/L (>200 mg/dl); iii) HDL cholesterol <0.9 mmol/L (3.5
mg/dl); iv) current cigarette smoker; v) any evidence of previous vascular disease

- Provision of informed consent

Exclusion Criteria:

- Current use of any vitamin supplements containing folic acid >200 micrograms/day. The
patients taking such vitamin supplements can be asked if they agree to discontinue
these supplements. If they agree, they can be randomized to the study following a one
month wash-out period.

- Known previous adverse reactions to folic acid and/or vitamin B6 and/or B12.

- Planned cardiac, peripheral or cerebrovascular revascularization, defined as a
decision taken by the patient and his or her physician(s) to perform surgical or
percutaneous transluminal revascularization within the next 6 months.

- Hemodynamically significant primary valvular outflow tract obstruction (e.g. mitral
stenosis, asymmetric septal hypertrophy, malfunctioning prosthetic valve).

- Constrictive pericarditis.

- Complex congenital heart disease.

- Syncopal episodes presumed to be due to uncontrolled life-threatening arrhythmias
(asymptomatic arrhythmias including ventricular tachycardia are not exclusion
criteria.

- Uncontrolled hypertension.

- Cor pulmonale.

- Heart transplant recipient.

- Other important non-cardiovascular disease(s) expected to limit compliance and/or
impact on patient's ability to complete the study, such as: *history of alcohol or
drug abuse, *psychiatric disorders, *senility, *severe physical disability,
*illnesses including terminal stage of cancer and other major systemic illnesses
expected to limit the patient's ability to comply with the study protocol and to
complete the study.