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Homocysteine-lowering trials for prevention of heart disease and stroke.
Semin Vasc Med 2005; 5(2):215-22SV

Abstract

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.

Authors+Show Affiliations

Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Radcliffe Infirmary, Oxford, England.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16047274

Citation

Clarke, Robert. "Homocysteine-lowering Trials for Prevention of Heart Disease and Stroke." Seminars in Vascular Medicine, vol. 5, no. 2, 2005, pp. 215-22.
Clarke R. Homocysteine-lowering trials for prevention of heart disease and stroke. Semin Vasc Med. 2005;5(2):215-22.
Clarke, R. (2005). Homocysteine-lowering trials for prevention of heart disease and stroke. Seminars in Vascular Medicine, 5(2), pp. 215-22.
Clarke R. Homocysteine-lowering Trials for Prevention of Heart Disease and Stroke. Semin Vasc Med. 2005;5(2):215-22. PubMed PMID: 16047274.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Homocysteine-lowering trials for prevention of heart disease and stroke. A1 - Clarke,Robert, PY - 2005/7/28/pubmed PY - 2005/9/30/medline PY - 2005/7/28/entrez SP - 215 EP - 22 JF - Seminars in vascular medicine JO - Semin Vasc Med VL - 5 IS - 2 N2 - 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. SN - 1528-9648 UR - https://www.unboundmedicine.com/medline/citation/16047274/Homocysteine_lowering_trials_for_prevention_of_heart_disease_and_stroke_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16047274.ui DB - PRIME DP - Unbound Medicine ER -