In this third up date of the Cochrane review , there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6 , B9 or B12 given alone or in combination comparing with placebo on myocardial infa rct ion , death from any cause or adverse events .
BACKGROUND Cardiovascular disease , which includes coronary artery disease , stroke and peripheral vascular disease , is a leading cause of death worldwide .
Homocysteine is an amino acid with biological functions in methionine metabolism .
A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level .
The impact of homocysteine-lowering interventions , given to patients in the form of vitamins B6 , B9 or B12 supplements , on cardiovascular events has been investigated .
This is an up date of a review previously published in 2009 , 2013 , and 2015 .
OBJECTIVES To determine whether homocysteine-lowering interventions , provided to patients with and without pre-existing cardiovascular disease are effective in preventing cardiovascular events , as well as reducing all-cause mortality , and to evaluate their safety .
Effects of 2-year vitamin B12 and folic acid supplementation in hyperhomocysteinemic elderly on arterial stiffness and cardiovascular outcomes within the B-PROOF trial
Introduction : Hyperhomocysteinemia is an important cardiovascular risk indicator in the oldest old , and is associated with elevated arterial stiffness in this age group . Since several intervention trials reported a lack of benefit of B-vitamin supplementation on cardiovascular outcomes , we aim ed to investigate the effect of B-vitamin supplementation on arterial stiffness and atherosclerosis in hyperhomocysteinemic elderly patients . Methods : The B-PROOF study is a double-blind , r and omized controlled trial , including 2919 elderly aged at least 65 years , with hyperhomocysteinemia ( 12–50 & mgr;mol/l ) , treated with B-vitamins ( 500 & mgr;g vitamin B12 and 400 & mgr;g folic acid ) or placebo for 2 years . In a subgroup ( n = 569 ) , the effect of B-vitamins on pulse wave velocity ( PWV ) was investigated as a measurement of arterial stiffness . To measure atherosclerosis , carotid intima – media thickness ( IMT ) measures had been used . Incidents of cardiovascular and cerebrovascular events were determined via structured question naires , and blood pressure was also measured . Results : Compared to placebo , B-vitamin supplementation  lowered serum homocysteine by 3.6 & mgr;mol/l ( P < 0.001 ) . Analysis of covariance showed no effect of supplementation on PWV levels , and this was not different for patients without increased arterial stiffness at baseline . Furthermore , no effect on carotid IMT was observed . Discussion : Vitamin B12 and folic acid supplementation in hyperhomocysteinemic elderly patients have no effect on PWV or carotid IMT . Further research will still be necessary to unravel the effects and pathways of homocysteine-lowering treatment on cardiovascular outcomes
In this third up date of the Cochrane review , there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6 , B9 or B12 given alone or in combination comparing with placebo on myocardial infa rct ion , death from any cause or adverse events .
BACKGROUND Cardiovascular disease , which includes coronary artery disease , stroke and peripheral vascular disease , is a leading cause of death worldwide .
Homocysteine is an amino acid with biological functions in methionine metabolism .
A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level .
The impact of homocysteine-lowering interventions , given to patients in the form of vitamins B6 , B9 or B12 supplements , on cardiovascular events has been investigated .
This is an up date of a review previously published in 2009 , 2013 , and 2015 .
OBJECTIVES To determine whether homocysteine-lowering interventions , provided to patients with and without pre-existing cardiovascular disease are effective in preventing cardiovascular events , as well as reducing all-cause mortality , and to evaluate their safety .