Association between serum folate and cardiovascular deaths among adults with hypertension

Nkemjika, Stanley; Ifebi, Emeka; Cowan, Logan; Fung, Isaac Chun-Hai; Twum, Felix; Liu, Fengqi; Zhang, Jian

doi:10.1038/s41430-019-0533-7

Cited by 23 publications

(13 citation statements)

References 39 publications

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“…Among participants with rheumatoid arthritis in NHANES III (1988)(1989)(1990)(1991)(1992)(1993)(1994) and 2011, circulating folate levels were inversely associated with risk of all-cause mortality and CVD mortality, 25 whereas a U-shaped association between serum folate level and CVD mortality was observed among adults with hypertension. 26 However, among adults with T2D, the evidence regarding folate status and long-term health outcomes is limited and mixed. One previous study of 689 US adults found that serum folate level was not associated with the risk of CVD mortality among participants with…”

Section: Discussionmentioning

confidence: 99%

Associations of Serum Folate and Vitamin B₁₂ Levels With Cardiovascular Disease Mortality Among Patients With Type 2 Diabetes

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Associations of Serum Folate and Vitamin B₁₂ Levels With Cardiovascular Disease Mortality Among Patients With Type 2 Diabetes

et al. 2022

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“…Although the associations between folate levels and mortality have been previously investigated, the current evidence is not yet conclusive: some studies did not find any significant associations (18,19); among studies that did, J-or U-shaped associations (20)(21)(22)(23), positive linear associations (24), and inverse associations (17,25,26) have all been reported; additionally, two studies found that only low folate levels were significantly associated with increased risk of mortality (27,28). However, most of the previous studies used serum folate as the main exposure, and only two studies used RBC folate in the analysis (21,24).…”

Section: Discussionmentioning

confidence: 58%

Associations of Serum and Red Blood Cell Folate With All-Cause and Cardiovascular Mortality Among Hypertensive Patients With Elevated Homocysteine

et al. 2022

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ObjectivesThis study aims to explore the associations between serum and red blood cell (RBC) folate as indicators of short- and long-term folate status, respectively, and all-cause as well as CVD mortality among hypertensive patients with elevated homocysteine.MethodsA prospective cohort study of the National Health and Nutrition Examination Survey (1999–2006) and 2015 Linked Mortality File was performed. All-cause and CVD mortality risk estimated using Cox proportional hazards models with adjusting for multiple potential covariates.ResultsA total of 1,753 hypertensive patients with elevated homocysteine [mean (SD) age, 68.5 (13.1)] were included in the analysis. During a median follow-up of 10.0 years, a total of 899 all-cause and 257 CVD deaths occurred. Compared the highest with the lowest quartile of RBC folate, the multivariable adjusted hazard ratios and 95% confidence intervals for all-cause and CVD death were 1.13 (0.92–1.39) and 1.47 (1.01–2.16) respectively. There was a significant and positive trend between RBC folate and the risk of CVD death (p for trend = 0.0196). No significant association was found between serum folate and mortality risk among the study sample.ConclusionsHigh level of RBC folate is associated with an increased risk of cardiovascular mortality among hypertensive patients with elevated homocysteine while serum folate has no such effects.

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“…Our results are roughly in agreement with a series of reports based on other population. 16 , 17 Although the underlying mechanisms by which lower folate level contributes to mortality remain unclear, some feasible explanations could be considered. Reports stated that insufficient folate would interfere with the DNA methylation, 18 yet others stated that folate deficiency could irritate a raised homocysteine level, 19 which was recognized as a risk factor of death.…”

Section: Discussionmentioning

confidence: 99%

Serum Folate and All-Cause Mortality is of Non-Linear Relationship Among Population with Chronic Kidney Disease: A Retrospective Cohort Study

Yan¹,

Zhang²,

Zeng³

et al. 2021

IJGM

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Aim A transition toward high serum folate concentrations has been noticed following the mandatory folate fortification. To explore this further, we studied the relationship between folate and health outcomes in population with chronic kidney disease (CKD). Methods We retrospectively explored the relationships between serum folate and risk of all-cause death in this population. We analyzed data of 2142 subjects with CKD who participated in the National Health and Nutrition Examination Survey (NHANES) 1999–2006. Vital status was followed through December 31, 2006. Results Cox regression was used to estimate hazard ratios (HRs) of mortality for individuals with serum folate in rest quintiles compared with individuals with the fourth quintile. After an average follow-up of 57.4 months with 157 deaths recorded, a reversed J-shaped association was revealed after conducting multivariable adjustment. The mortality rate in population with lower and higher folate levels were 8.29% and 12.67%, respectively, and the corresponding adjusted HRs were 2.41 (95% confidence interval, CI=1.32–4.40) and 2.10 (1.20–3.70). Kaplan–Meier curve showed survival benefits for the fourth quintile of serum folate as compared to the first and fifth quintile. Conclusion Serum folate concentrations may influence all-cause mortality in a non-linear pattern in the CKD population. It is reasonable to recommend periodic surveillance in the CKD population to maintain the serum folate concentration in an appropriate level.

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Association between serum folate and cardiovascular deaths among adults with hypertension

Cited by 23 publications

References 39 publications

Associations of Serum Folate and Vitamin B₁₂ Levels With Cardiovascular Disease Mortality Among Patients With Type 2 Diabetes

Associations of Serum Folate and Vitamin B₁₂ Levels With Cardiovascular Disease Mortality Among Patients With Type 2 Diabetes

Associations of Serum and Red Blood Cell Folate With All-Cause and Cardiovascular Mortality Among Hypertensive Patients With Elevated Homocysteine

Serum Folate and All-Cause Mortality is of Non-Linear Relationship Among Population with Chronic Kidney Disease: A Retrospective Cohort Study

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Association between serum folate and cardiovascular deaths among adults with hypertension

Cited by 23 publications

References 39 publications

Associations of Serum Folate and Vitamin B12 Levels With Cardiovascular Disease Mortality Among Patients With Type 2 Diabetes

Associations of Serum Folate and Vitamin B12 Levels With Cardiovascular Disease Mortality Among Patients With Type 2 Diabetes

Associations of Serum and Red Blood Cell Folate With All-Cause and Cardiovascular Mortality Among Hypertensive Patients With Elevated Homocysteine

Serum Folate and All-Cause Mortality is of Non-Linear Relationship Among Population with Chronic Kidney Disease: A Retrospective Cohort Study

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Associations of Serum Folate and Vitamin B₁₂ Levels With Cardiovascular Disease Mortality Among Patients With Type 2 Diabetes

Associations of Serum Folate and Vitamin B₁₂ Levels With Cardiovascular Disease Mortality Among Patients With Type 2 Diabetes