Homocysteine-lowering trials for prevention of heart disease and stroke.

Dietary supplementation with B-vitamins that lower plasma total homocysteine concentrations are expected to lower the risk of cardiovascular disease. Folic acid and vitamin B (12) lower blood homocysteine concentrations by about 25-30% in populations without folic acid fortification, but by only 10-...

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Main Author: Clarke, R
Format: Journal article
Language:English
Published: 2005
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author Clarke, R
author_facet Clarke, R
author_sort Clarke, R
collection OXFORD
description Dietary supplementation with B-vitamins that lower plasma total homocysteine concentrations are expected to lower the risk of cardiovascular disease. Folic acid and vitamin B (12) lower blood homocysteine concentrations by about 25-30% in populations without folic acid fortification, but by only 10-15% in populations with fortification. In observational studies, 25% lower homocysteine is associated with about 10% less coronary heart disease (CHD) and about 20% less stroke. This review examines the current status of 12 large-scale randomized trials of B-vitamin supplementation and risk of cardiovascular disease. Seven of these trials are being performed in populations without fortification (five involving participants with prior CHD, two with prior stroke) and five in populations with fortification (two with prior CHD, two with renal disease, and one with prior stroke). Many of these trials may not have included a sufficient number of people or lasted long enough to have adequate power to exclude false-negative results. Taken together, however, these trials involve 32,000 patients with prior vascular disease in unfortified populations and 20,000 (14,000 with vascular disease and 6000 with renal disease) patients in fortified populations. A metaanalysis of these trials should have adequate power to determine whether homocysteine-lowering vitamin supplements can reduce the risk of cardiovascular disease.
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spelling oxford-uuid:b518d86f-7dc5-4a16-94bc-b9daf30d7ad12022-03-27T04:30:52ZHomocysteine-lowering trials for prevention of heart disease and stroke.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b518d86f-7dc5-4a16-94bc-b9daf30d7ad1EnglishSymplectic Elements at Oxford2005Clarke, RDietary supplementation with B-vitamins that lower plasma total homocysteine concentrations are expected to lower the risk of cardiovascular disease. Folic acid and vitamin B (12) lower blood homocysteine concentrations by about 25-30% in populations without folic acid fortification, but by only 10-15% in populations with fortification. In observational studies, 25% lower homocysteine is associated with about 10% less coronary heart disease (CHD) and about 20% less stroke. This review examines the current status of 12 large-scale randomized trials of B-vitamin supplementation and risk of cardiovascular disease. Seven of these trials are being performed in populations without fortification (five involving participants with prior CHD, two with prior stroke) and five in populations with fortification (two with prior CHD, two with renal disease, and one with prior stroke). Many of these trials may not have included a sufficient number of people or lasted long enough to have adequate power to exclude false-negative results. Taken together, however, these trials involve 32,000 patients with prior vascular disease in unfortified populations and 20,000 (14,000 with vascular disease and 6000 with renal disease) patients in fortified populations. A metaanalysis of these trials should have adequate power to determine whether homocysteine-lowering vitamin supplements can reduce the risk of cardiovascular disease.
spellingShingle Clarke, R
Homocysteine-lowering trials for prevention of heart disease and stroke.
title Homocysteine-lowering trials for prevention of heart disease and stroke.
title_full Homocysteine-lowering trials for prevention of heart disease and stroke.
title_fullStr Homocysteine-lowering trials for prevention of heart disease and stroke.
title_full_unstemmed Homocysteine-lowering trials for prevention of heart disease and stroke.
title_short Homocysteine-lowering trials for prevention of heart disease and stroke.
title_sort homocysteine lowering trials for prevention of heart disease and stroke
work_keys_str_mv AT clarker homocysteineloweringtrialsforpreventionofheartdiseaseandstroke