Efficacy of folic acid when added to statin therapy in patients with hypercholesterolemia following acute myocardial infarction: a randomised pilot trial

Liem, Anho; Boven, A.J. van; Veeger, Nic J. G. M.; Withagen, Adrie J.; Medina, Ramon M. Robles de; Tijssen, Jan G.P.; Veldhuisen, D.J. van

doi:10.1016/j.ijcard.2003.02.001

Cited by 64 publications

(53 citation statements)

References 12 publications

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“…Another study (Schnyder et al 2001) has shown an effect of a combination of folic acid (1 mg), cobalamin (400 mg) and pyridoxine (10 mg) v. placebo on restenosis after 6 months in 205 patients after successful coronary angioplasty. Only three published studies (Baker et al 2002;Liem et al 2004;Toole et al 2004) have to date examined the effect of B-vitamin supplementation on hard clinical end points. The Vitamin Intervention for Stroke Prevention trial (Toole et al 2004), which randomised 3680 adults with non-disabling cerebral infarction to daily high-dose B-vitamins (25 mg pyridoxine, 0 .…”

Section: Clinical Trial Evidence Linking Micronutrient Status With DImentioning

confidence: 99%

“…7 years, showed a reduction in non-fatal myocardial infarction, but no reduction in total deaths. The final study (Liem et al 2004) was a pilot study that examined the effect of 5 mg folic acid/d when added to statin therapy on the incidence of recurrent major clinical events up to 1 year post-myocardial infarction. No beneficial additive effects on cardiovascular mortality or morbidity were seen.…”

Section: Clinical Trial Evidence Linking Micronutrient Status With DImentioning

confidence: 99%

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Micronutrients: dietary intake v. supplement use

Woodside¹,

McCall²,

McGartland³

et al. 2005

Proc. Nutr. Soc.

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Whilst clinical deficiency of micronutrients is uncommon in the developed world, a suboptimal intake of certain micronutrients has been linked with an increased risk of chronic diseases such as CVD and cancer. Attention has therefore focused on increasing micronutrient status in order to theoretically reduce chronic disease risk. Increasing micronutrient status can involve a number of approaches: increasing dietary intake of micronutrient-rich foods; food fortification; use of supplements. Observational cohort studies have demonstrated an association between high intakes of micronutrients such as vitamin E, vitamin C, folic acid and β-carotene, and lower risk of CHD, stroke and cancer at various sites. However, randomised intervention trials of micronutrient supplements have, to date, largely failed to show an improvement in clinical end points. The discordance between data from cohort studies and the results so far available from clinical trials remains to be explained. One reason may be that the complex mixture of micronutrients found, for example, in a diet high in fruit and vegetables may be more effective than large doses of a small number of micronutrients, and therefore that intervention studies that use single micronutrient supplements are unlikely to produce a lowering of disease risk. Studies concentrating on whole foods (e.g. fruit and vegetables) or diet pattern (e.g. Mediterranean diet pattern) may be more effective in demonstrating an effect on clinical end points. The present review will consider the clinical trial evidence for a beneficial effect of micronutrient supplements on health, and review the alternative approaches to the study of dietary intake of micronutrients.

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Section: Clinical Trial Evidence Linking Micronutrient Status With DImentioning

confidence: 99%

Section: Clinical Trial Evidence Linking Micronutrient Status With DImentioning

confidence: 99%

Micronutrients: dietary intake v. supplement use

Woodside¹,

McCall²,

McGartland³

et al. 2005

Proc. Nutr. Soc.

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“…The reduction of total cholesterol concentration was similar in patients administered with fluvastatin only and in those who were also given folic acid. In both groups, severe cardiovascular complications occurred with the same frequency-in 31% of patients (21). The results of the research concerning the impact of the reduction of homocysteine concentration through supplementation with folic acid, vitamin B12 and vitamin B6 on the risk of the occurrence of cardiovascular diseases and the development of hypertension are not unambiguous.…”

Section: Discussionmentioning

confidence: 94%

The Impact of Supplementation with Folic Acid on Homocysteine Concentration and Selected Lipoprotein Parameters in Patients with Primary Hypertension

Baszczuk¹,

Thielemann²,

Musialik³

et al. 2017

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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SummaryThe aim of the study was the assessment of the impact of supplementation with folic acid on the concentration of homocysteine, total cholesterol (TC), HDL-and LDLcholesterol, triglycerides (TG), apoprotein AI (apoAI) and apoprotein B (apoB) in patients suffering from primary hypertension. The examined group comprised 42 patients suffering from primary hypertension. All examined patients underwent laboratory tests as follows: concentration of homocysteine, folic acid, TC, LDL-cholesterol, HDL-cholesterol, TG, apoAI and apoB. All patients were orally administered with 15 mg of folic acid per day for 45 d. After this period, all laboratory tests were repeated. Homocysteine concentration was measured by the FPIA method, concentrations of apoAI and apoB were measured by the nephelometric method, and other parameters with routine methods. After administration of 15 mg of folic acid to patients with primary hypertension, a considerable decrease in the concentration of homocysteine was observed in parallel with a substantive growth of HDLcholesterol, as well as apoprotein AI concentrations and a reduction of the apoprotein B concentration. Results of statistical analysis indicated a significant correlation between the decline in homocysteine concentration and the increase in HDL-cholesterol concentration, as well as between the increase of folic acid concentration and the increase in apoAI concentration in patients following the intake of folic acid. The drop in homocysteine concentration through the supplementation with folic acid can cause quantitative changes in the lipid and lipoprotein parameters which, in consequence, may lead to the mitigation of risk concerning the development of atherosclerosis. Key Words hypertension, hyperhomocysteinaemia, cholesterol, triglycerides, apoproteins Hypertension is one of the most common symptoms of cardiovascular diseases. Ninety percent of affected patients are diagnosed with primary hypertension. The etiology of this disease includes numerous genetic, environmental and neuro-hormonal factors, which often co-exist and are linked one to another. Due to that fact, hypertension is frequently accompanied by metabolic disorders such as obesity, diabetes, and hyperlipidaemia. These diseases are often also accompanied by mild chronic inflammation, disorders of the coagulation system and fibrinolysis, as well as hyperhomocysteinaemia. Some of the cardiovascular disease risk factors may be modified through a change in lifestyle and medication. The positive impact of modified standard risk factors, such as disturbances in lipid and carbohydrate metabolism disorders, as well as obesity, is relatively well documented.As far as hyperhomocysteinaemia is concerned, studies on its importance in the development of hypertension, as well as on the impact of its treatment in eliminating the risk of cardiovascular diseases, are still being carried out. High blood pressure is often accompanied by hyperhomocysteinaemia. High level of homocysteine could adversely affect the synthesis and bioacc...

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“…After 1 year of combined folic acid and statin therapy in hypercholesterolemic postmyocardial infarct patients, despite a decrease in homocysteine concentrations, there was no significant additive effect of folic acid on cardiovascular mortality or morbidity (26). Folic acid treatment for 1 year in heart transplant recipients resulted in a decrease in homocysteine concentration but had no significant effect on the progression of coronary intimal area (27).…”

Section: Folic Acid (And Other B Vitamins)mentioning

confidence: 96%

Nutrient supplements and cardiovascular disease: a heartbreaking story

Lichtenstein

2009

Journal of Lipid Research

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Observational data have identified associations between carotenoids, folic acid, and vitamin E, or metabolites altered by these nutrients, and cardiovascular disease (CVD) risk. Despite biological plausibility, for the most part, data derived from nutrient supplement trials using moderate to high doses of single nutrients or nutrient combinations (exceeding amounts to avoid nutrient deficiency) have been disappointing. The data for vitamin D is not yet adequate to evaluate; observational data suggest were a relationship to exist it would be related to nutrient insufficiency. There is some evidence that use of nutrient supplements intended to decrease CVD risk has resulted in unanticipated adverse consequences. Potential discrepancies between observational and interventional data include concerns of residual confounding by diet and lifestyle patterns, publication bias against studies with null or negative outcomes, reliance on secondary rather than primary prevention trials, and unaccounted for contribution of genotypic variations. At this time there are insufficient data to recommend the routine use of nutrient supplements to prevent or treat CVD. In the recent past we have learned a great deal about anticipated and unanticipated consequences of nutrient supplementation and cardiovascular outcomes. As a result, we are in a better position to adjudicate new potential relationships as data emerge.-Lichtenstein, A. H. Nutrient supplements and cardiovascular disease: a heartbreaking story. J. Lipid Res. 2009. 50: S429-S433. Supplementary key words CVDHope springs eternal that a single or combination nutrient supplement will be identified to dramatically reduce cardiovascular disease (CVD) risk and will require no more dietary restraint or physical exertion than the quick sideward twist of the wrist (open container) and front hand bend (insert pill in mouth). The evidence to date, however, has yet to identify a nutrient supplement meeting these criteria and, in some cases, raises concern regarding unintended adverse consequences. This mini-review provides a short synopsis of the topic. It is limited to essential nutrients. The order of presentation is arranged alphabetically. CAROTENOIDSA number of retrospective and prospective longitudinal studies have identified an inverse association between carotenoid intake or plasma/serum concentrations and CVD risk (as reviewed in Ref. 1). The biological mechanism for these associations has been attributed to the antioxidant potential of carotenoids (2).Results from a series of intervention trials using bcarotene supplements, the major dietary carotenoid, have not supported the hypothesis that b-carotene reduces CVD risk (as reviewed in Refs. 1, 3). It is not clear why there is a discrepancy between the observational and interventional data; nor is it possible to determine whether the putative factor(s) in the observational studies was the b-carotene, other carotenoids, or phytochemicals occurring in the same foods as carotenoids (fruits and vegetables), or dietary pa...

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Efficacy of folic acid when added to statin therapy in patients with hypercholesterolemia following acute myocardial infarction: a randomised pilot trial

Cited by 64 publications

References 12 publications

Micronutrients: dietary intake v. supplement use

Micronutrients: dietary intake v. supplement use

The Impact of Supplementation with Folic Acid on Homocysteine Concentration and Selected Lipoprotein Parameters in Patients with Primary Hypertension

Nutrient supplements and cardiovascular disease: a heartbreaking story

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