Effects of B-vitamins on plasma homocysteine concentrations and on risk of cardiovascular disease and dementia.

PURPOSE OF REVIEW: Dietary supplementation with folic acid and vitamin B12 lowers blood homocysteine concentrations, but it is not known if this reduces the risk of coronary heart disease and stroke. RECENT FINDINGS: Recent evidence suggests that the maximum reduction in plasma homocysteine concentr...

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Main Authors: Clarke, R, Lewington, S, Sherliker, P, Armitage, J
Format: Journal article
Language:English
Published: 2007
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author Clarke, R
Lewington, S
Sherliker, P
Armitage, J
author_facet Clarke, R
Lewington, S
Sherliker, P
Armitage, J
author_sort Clarke, R
collection OXFORD
description PURPOSE OF REVIEW: Dietary supplementation with folic acid and vitamin B12 lowers blood homocysteine concentrations, but it is not known if this reduces the risk of coronary heart disease and stroke. RECENT FINDINGS: Recent evidence suggests that the maximum reduction in plasma homocysteine concentrations is obtained with 0.8 mg of folic acid and doses of 0.2 mg and 0.4 mg of folic acid are associated with about 60 and 90%, respectively, of this maximal effect. Among 12 large trials (involving a total of 52,000 participants) that are currently assessing the effects of B-vitamins on risk of coronary heart disease and stroke, results are available for four trials involving 14 000 participants. A meta-analysis of these four trials demonstrates no beneficial effects of B-vitamins on coronary heart disease (OR 0.99; 95% CI 0.88-1.10) or stroke (OR 89; 95% CI 0.76-1.05) or the combination of coronary heart disease and stroke (OR 0.98; 95% CI 0.90-1.08). The confidence intervals around the odds ratios for these completed trials are compatible with a 10% difference in risk for coronary heart disease and 20% difference for stroke associated with a 25% lower homocysteine predicted by the observational epidemiological studies. SUMMARY: The results of the ongoing homocysteine-lowering trials are required before making recommendations on the use of B-vitamins for prevention of vascular disease.
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spelling oxford-uuid:f8e3fa56-c449-4b2d-a788-2bba1260af3c2022-03-27T12:54:07ZEffects of B-vitamins on plasma homocysteine concentrations and on risk of cardiovascular disease and dementia.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f8e3fa56-c449-4b2d-a788-2bba1260af3cEnglishSymplectic Elements at Oxford2007Clarke, RLewington, SSherliker, PArmitage, JPURPOSE OF REVIEW: Dietary supplementation with folic acid and vitamin B12 lowers blood homocysteine concentrations, but it is not known if this reduces the risk of coronary heart disease and stroke. RECENT FINDINGS: Recent evidence suggests that the maximum reduction in plasma homocysteine concentrations is obtained with 0.8 mg of folic acid and doses of 0.2 mg and 0.4 mg of folic acid are associated with about 60 and 90%, respectively, of this maximal effect. Among 12 large trials (involving a total of 52,000 participants) that are currently assessing the effects of B-vitamins on risk of coronary heart disease and stroke, results are available for four trials involving 14 000 participants. A meta-analysis of these four trials demonstrates no beneficial effects of B-vitamins on coronary heart disease (OR 0.99; 95% CI 0.88-1.10) or stroke (OR 89; 95% CI 0.76-1.05) or the combination of coronary heart disease and stroke (OR 0.98; 95% CI 0.90-1.08). The confidence intervals around the odds ratios for these completed trials are compatible with a 10% difference in risk for coronary heart disease and 20% difference for stroke associated with a 25% lower homocysteine predicted by the observational epidemiological studies. SUMMARY: The results of the ongoing homocysteine-lowering trials are required before making recommendations on the use of B-vitamins for prevention of vascular disease.
spellingShingle Clarke, R
Lewington, S
Sherliker, P
Armitage, J
Effects of B-vitamins on plasma homocysteine concentrations and on risk of cardiovascular disease and dementia.
title Effects of B-vitamins on plasma homocysteine concentrations and on risk of cardiovascular disease and dementia.
title_full Effects of B-vitamins on plasma homocysteine concentrations and on risk of cardiovascular disease and dementia.
title_fullStr Effects of B-vitamins on plasma homocysteine concentrations and on risk of cardiovascular disease and dementia.
title_full_unstemmed Effects of B-vitamins on plasma homocysteine concentrations and on risk of cardiovascular disease and dementia.
title_short Effects of B-vitamins on plasma homocysteine concentrations and on risk of cardiovascular disease and dementia.
title_sort effects of b vitamins on plasma homocysteine concentrations and on risk of cardiovascular disease and dementia
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