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 .
Effect of 3 y of folic acid supplementation on the progression of carotid intima-media thickness and carotid arterial stiffness in older adults.
BACKGROUND Observational studies have shown that low folate and elevated homocysteine concentrations are risk factors for vascular disease in the general population . R and omized controlled trials in vascular patients have failed to show that folic acid reduces the risk of recurrent vascular disease , whereas such trials are lacking in the general population . OBJECTIVE The objective was to determine whether folic acid supplementation reduces the progression of atherosclerosis as measured by common carotid intima-media thickness (CIMT)-a vali date d marker of atherosclerosis and predictor of vascular disease risk . DESIGN A r and omized , double-blind , placebo-controlled study in 819 men and postmenopausal women aged 50 - 70 y , free-living in the Netherl and s , and with a total homocysteine concentration ≥13 μmol/L at screening was conducted . Participants received either 800 μg folic acid or placebo daily for 3 y. Rate of change in CIMT and arterial distensibility were the primary and secondary outcomes , respectively . RESULTS Compared with placebo , serum folate increased by 577 % and plasma total homocysteine concentrations decreased by 26 % after 3 y of folic acid supplementation . The mean ( ±SE ) rate of change in CIMT was 1.9 ± 0.9 μm/y in the folic acid arm and 1.3 ± 0.8 μm/y in the placebo arm ( mean difference : 0.7 μm/y ; 95 % CI : -1.8 , 3.1 μm/y ; P = 0.59 ) . No difference was observed ( P = 0.23 ) between the rates of change in distensibility in the folic acid arm ( -0.53 ± 0.06 × 10(-3 ) kPa(-1 ) ) and in the placebo arm ( -0.62 ± 0.06 × 10(-3 ) kPa(-1 ) ) . CONCLUSION Despite a considerable increase in folate concentrations and a reduction in total homocysteine concentrations , 3-y folic acid supplementation did not slow down atherosclerotic progression or arterial stiffening . This trial was registered at clinical trials.gov as NCT00110604
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 .