I have just installed Vista Business 64-bit onto my Macbook, replacing Vista Ultimate 32-bit, and it works perfectly using the drivers from the new Mac Pro version of Boot Camp (torrent them!). I had to get the video card drivers off intel's website and it works flawlessly - no driver issues at all. I haven't done any benchmarks, but I can now play Portal without the frame rate dropping to an unplayable level when you, you know, fire a portal, which always happened with 32-bit Ultimate. Apparently source games benefit from 64-bit quite a lot. Also, all 4GB of ram can now be seen. I say it's worth a try.
Here's some proof. View full size and it should be self explanatory.
P.s. If you're thinking of doing this, check the search box in the top right of the screen shot.