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Folic Acid Supplementation does not Reduce Cardiovascular Risk
Written by Jeanne Bohm, Ph.D.   
A meta-analysis of 165 previous studies suggests that folic acid supplementation does not decrease the risk of coronary artery disease or stroke (JAMA, Dec. 2006). This conclusion contradicts previous claims on the effect of folic acid supplementation on cardiovascular risks.

Cardiovascular disease (CVD) is the leading cause of death in the world, accounting for 30.9 percent of deaths world-wide and 37.3 percent of deaths in the United States. Approximately 71.3 million people in the U.S. have some form of cardiovascular disease.

Previous epidemiologic studies have suggested that increased folate intake is related to a lower risk of cardiovascular disease. Randomized, controlled trials indicated that dietary folic acid supplementation reduces blood homocysteine levels.Since elevated homocysteine levels are associated with an increased risk of CVD, reduced homocysteine levels suggested that folate supplementation reduced CVD risk.

The report by Lydia A. Bazzano, M.D., Ph.D. and colleagues suggests, however, a correlation between folate supplementation and reduced cardiovascular risks are not substantiated. The authors performed a meta-analysis of 12 randomized clinical trials to determine the relationship between folic acid supplementation and the risk of CVD and all-cause death among persons with pre-existing vascular disease.

The researchers found that the folic acid supplementation groups had a lower proportion of events compared with the control group for CVD (18.3 percent vs. 19.2 percent); Coronary Artery Disease (11.4 percent vs. 10.6 percent); stroke, 4.7 percent vs. 5.8 percent; and all-cause death (12.0 percent vs. 12.3 percent). But, importantly, they also found that the previous studies lacked sufficient statistical power to draw a link between the supplementation and risk reduction.

The researchers concluded that folic acid supplementation is ineffective in the secondary prevention of CVD among patients with vascular diseases. The authors believe it is more important to focus on strategies related to smoking cessation, lipid reduction, treatment of hypertension and diabetes, maintenance of a healthy weight, and physical activity.


JAMA Media Release

Effect of Folic Acid Supplementation on Risk of Cardiovascular Diseases: A Meta-analysis of Randomized Controlled Trials. JAMA. 2006;296:2720-2726.

About the Author

Jeanne Bohm, Ph.D. is a cancer biologist by training, a medical writer and an experienced science educator.

The author has no financial relationship to any of the companies listed in the article.

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