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Effect of folic acid supplementation on cardiovascular outcomes: a systematic review and meta-analysis.
PLoS One 2011; 6(9):e25142Plos

Abstract

BACKGROUND

Folic acid is widely used to lower homocysteine concentrations and prevent adverse cardiovascular outcomes. However, the effect of folic acid on cardiovascular events is not clear at the present time. We carried out a comprehensive systematic review and meta-analysis to assess the effects of folic acid supplementation on cardiovascular outcomes.

METHODOLOGY AND PRINCIPAL FINDINGS

We systematically searched Medline, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles, and proceedings of major meetings for relevant literature. We included randomized placebo-controlled trials that reported on the effects of folic acid on cardiovascular events compared to placebo. Of 1594 identified studies, we included 16 trials reporting data on 44841 patients. These studies reported 8238 major cardiovascular events, 2001 strokes, 2917 myocardial infarctions, and 6314 deaths. Folic acid supplementation as compared to placebo had no effect on major cardiovascular events (RR, 0.98; 95% CI, 0.93-1.04), stroke (RR, 0.89; 95% CI,0.78-1.01), myocardial infarction (RR, 1.00; 95% CI, 0.93-1.07), or deaths from any cause (RR, 1.00;95% CI, 0.96-1.05). Moreover, folic acid as compared to placebo also had no effect on the following secondary outcomes: risk of revascularization (RR, 1.05; 95%CI, 0.95-1.16), acute coronary syndrome (RR, 1.06; 95%CI, 0.97-1.15), cancer (RR, 1.08; 95%CI, 0.98-1.21), vascular death (RR, 0.94; 95%CI,0.88-1.02), or non-vascular death (RR, 1.06; 95%CI, 0.97-1.15).

CONCLUSION/SIGNIFICANCE

Folic acid supplementation does not effect on the incidence of major cardiovascular events, stroke, myocardial infarction or all cause mortality.

Authors+Show Affiliations

Department of Health Statistics, Second Military Medical University, Shanghai, China.No affiliation info availableNo 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
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

21980387

Citation

Zhou, Yu-Hao, et al. "Effect of Folic Acid Supplementation On Cardiovascular Outcomes: a Systematic Review and Meta-analysis." PloS One, vol. 6, no. 9, 2011, pp. e25142.
Zhou YH, Tang JY, Wu MJ, et al. Effect of folic acid supplementation on cardiovascular outcomes: a systematic review and meta-analysis. PLoS ONE. 2011;6(9):e25142.
Zhou, Y. H., Tang, J. Y., Wu, M. J., Lu, J., Wei, X., Qin, Y. Y., ... He, J. (2011). Effect of folic acid supplementation on cardiovascular outcomes: a systematic review and meta-analysis. PloS One, 6(9), pp. e25142. doi:10.1371/journal.pone.0025142.
Zhou YH, et al. Effect of Folic Acid Supplementation On Cardiovascular Outcomes: a Systematic Review and Meta-analysis. PLoS ONE. 2011;6(9):e25142. PubMed PMID: 21980387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of folic acid supplementation on cardiovascular outcomes: a systematic review and meta-analysis. AU - Zhou,Yu-Hao, AU - Tang,Jian-Yuan, AU - Wu,Mei-Jing, AU - Lu,Jian, AU - Wei,Xin, AU - Qin,Ying-Yi, AU - Wang,Chao, AU - Xu,Jin-Fang, AU - He,Jia, Y1 - 2011/09/28/ PY - 2011/02/28/received PY - 2011/08/26/accepted PY - 2011/10/8/entrez PY - 2011/10/8/pubmed PY - 2012/3/6/medline SP - e25142 EP - e25142 JF - PloS one JO - PLoS ONE VL - 6 IS - 9 N2 - BACKGROUND: Folic acid is widely used to lower homocysteine concentrations and prevent adverse cardiovascular outcomes. However, the effect of folic acid on cardiovascular events is not clear at the present time. We carried out a comprehensive systematic review and meta-analysis to assess the effects of folic acid supplementation on cardiovascular outcomes. METHODOLOGY AND PRINCIPAL FINDINGS: We systematically searched Medline, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles, and proceedings of major meetings for relevant literature. We included randomized placebo-controlled trials that reported on the effects of folic acid on cardiovascular events compared to placebo. Of 1594 identified studies, we included 16 trials reporting data on 44841 patients. These studies reported 8238 major cardiovascular events, 2001 strokes, 2917 myocardial infarctions, and 6314 deaths. Folic acid supplementation as compared to placebo had no effect on major cardiovascular events (RR, 0.98; 95% CI, 0.93-1.04), stroke (RR, 0.89; 95% CI,0.78-1.01), myocardial infarction (RR, 1.00; 95% CI, 0.93-1.07), or deaths from any cause (RR, 1.00;95% CI, 0.96-1.05). Moreover, folic acid as compared to placebo also had no effect on the following secondary outcomes: risk of revascularization (RR, 1.05; 95%CI, 0.95-1.16), acute coronary syndrome (RR, 1.06; 95%CI, 0.97-1.15), cancer (RR, 1.08; 95%CI, 0.98-1.21), vascular death (RR, 0.94; 95%CI,0.88-1.02), or non-vascular death (RR, 1.06; 95%CI, 0.97-1.15). CONCLUSION/SIGNIFICANCE: Folic acid supplementation does not effect on the incidence of major cardiovascular events, stroke, myocardial infarction or all cause mortality. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/21980387/Effect_of_folic_acid_supplementation_on_cardiovascular_outcomes:_a_systematic_review_and_meta_analysis_ L2 - http://dx.plos.org/10.1371/journal.pone.0025142 DB - PRIME DP - Unbound Medicine ER -