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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; 37(2):547-9S

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

School of Medicine and Pharmacology, University of Western Australia, Perth, Australia. leonflic@cyllene.uwa.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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., ... 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), pp. 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_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.STR.0000198815.07315.68?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -