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Efficacy of B vitamins in lowering homocysteine in older men: maximal effects for those with B12 deficiency and hyperhomocysteinemia.
Stroke. 2006 Feb; 37(2):547-9.S

Abstract

BACKGROUND AND PURPOSE

A higher plasma concentration of total homocysteine (tHcy) is associated with a greater risk of cardiovascular events. Previous studies, largely in younger individuals, have shown that B vitamins lowered tHcy by substantial amounts and that this effect is greater in people with higher tHcy and lower folate levels.

METHODS

We undertook a 2-year, double-blind, placebo-controlled, randomized trial in 299 men aged > or =75 years, comparing treatment with a daily tablet containing 2 mg of folate, 25 mg of B6, and 400 microg of B12 or placebo. The study groups were balanced regarding age (mean+/-SD, 78.9+/-2.8 years), B vitamins, and tHcy at baseline.

RESULTS

Among the 13% with B12 deficiency, the difference in mean changes in treatment and control groups for tHcy was 6.74 micromol/L (95% CI, 3.94 to 9.55 micromol/L) compared with 2.88 micromol/L (95% CI, 0.07 to 5.69 micromol/L) for all others. Among the 20% with hyperhomocysteinaemia, the difference between mean changes in treatment and control groups for men with high plasma tHcy compared with the rest of the group was 2.8 micromol/L (95% CI, 0.6 to 4.9 micromol/L). Baseline vitamin B12, serum folate, and tHcy were significantly associated with changes in plasma tHcy at follow-up (r=0.252, r=0.522, and r=-0.903, respectively; P=0.003, <0.001, and <0.001, respectively) in the vitamin group.

CONCLUSIONS

The tHcy-lowering effect of B vitamins was maximal in those who had low B12 or high tHcy levels. Community-dwelling older men, who are likely to be deficient in B12 or have hyperhomocysteinemia, may be most likely to benefit from treatment with B vitamins.

Authors+Show Affiliations

Flicker L
School of Medicine and Pharmacology, University of Western Australia, Perth, Australia. leonflic@cyllene.uwa.edu.au
Vasikaran SD
No affiliation info available
Thomas J
No affiliation info available
Acres JM
No affiliation info available
Norman P
No affiliation info available
Jamrozik K
No affiliation info available
Hankey GJ
No affiliation info available
Almeida OP
No affiliation info available

MeSH

AgedDietary SupplementsDouble-Blind MethodFolic AcidHomocysteineHumansHyperhomocysteinemiaMalePlacebosTime FactorsTreatment OutcomeVitamin B 12Vitamin B 12 DeficiencyVitamin B Complex

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16373648

Citation

Flicker, Leon, et al. "Efficacy of B Vitamins in Lowering Homocysteine in Older Men: Maximal Effects for Those With B12 Deficiency and Hyperhomocysteinemia." Stroke, vol. 37, no. 2, 2006, pp. 547-9.
Flicker L, Vasikaran SD, Thomas J, et al. Efficacy of B vitamins in lowering homocysteine in older men: maximal effects for those with B12 deficiency and hyperhomocysteinemia. Stroke. 2006;37(2):547-9.
Flicker, L., Vasikaran, S. D., Thomas, J., Acres, J. M., Norman, P., Jamrozik, K., Hankey, G. J., & Almeida, O. P. (2006). Efficacy of B vitamins in lowering homocysteine in older men: maximal effects for those with B12 deficiency and hyperhomocysteinemia. Stroke, 37(2), 547-9.
Flicker L, et al. Efficacy of B Vitamins in Lowering Homocysteine in Older Men: Maximal Effects for Those With B12 Deficiency and Hyperhomocysteinemia. Stroke. 2006;37(2):547-9. PubMed PMID: 16373648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of B vitamins in lowering homocysteine in older men: maximal effects for those with B12 deficiency and hyperhomocysteinemia. AU - Flicker,Leon, AU - Vasikaran,Samuel D, AU - Thomas,Jenny, AU - Acres,John M, AU - Norman,Paul, AU - Jamrozik,Konrad, AU - Hankey,Graeme J, AU - Almeida,Osvaldo P, Y1 - 2005/12/22/ PY - 2005/12/24/pubmed PY - 2006/3/2/medline PY - 2005/12/24/entrez SP - 547 EP - 9 JF - Stroke JO - Stroke VL - 37 IS - 2 N2 - BACKGROUND AND PURPOSE: A higher plasma concentration of total homocysteine (tHcy) is associated with a greater risk of cardiovascular events. Previous studies, largely in younger individuals, have shown that B vitamins lowered tHcy by substantial amounts and that this effect is greater in people with higher tHcy and lower folate levels. METHODS: We undertook a 2-year, double-blind, placebo-controlled, randomized trial in 299 men aged > or =75 years, comparing treatment with a daily tablet containing 2 mg of folate, 25 mg of B6, and 400 microg of B12 or placebo. The study groups were balanced regarding age (mean+/-SD, 78.9+/-2.8 years), B vitamins, and tHcy at baseline. RESULTS: Among the 13% with B12 deficiency, the difference in mean changes in treatment and control groups for tHcy was 6.74 micromol/L (95% CI, 3.94 to 9.55 micromol/L) compared with 2.88 micromol/L (95% CI, 0.07 to 5.69 micromol/L) for all others. Among the 20% with hyperhomocysteinaemia, the difference between mean changes in treatment and control groups for men with high plasma tHcy compared with the rest of the group was 2.8 micromol/L (95% CI, 0.6 to 4.9 micromol/L). Baseline vitamin B12, serum folate, and tHcy were significantly associated with changes in plasma tHcy at follow-up (r=0.252, r=0.522, and r=-0.903, respectively; P=0.003, <0.001, and <0.001, respectively) in the vitamin group. CONCLUSIONS: The tHcy-lowering effect of B vitamins was maximal in those who had low B12 or high tHcy levels. Community-dwelling older men, who are likely to be deficient in B12 or have hyperhomocysteinemia, may be most likely to benefit from treatment with B vitamins. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/16373648/Efficacy_of_B_vitamins_in_lowering_homocysteine_in_older_men:_maximal_effects_for_those_with_B12_deficiency_and_hyperhomocysteinemia_ DB - PRIME DP - Unbound Medicine ER -