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Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women.
JAMA 1998; 279(5):359-64JAMA

Abstract

CONTEXT

Hyperhomocysteinemia is caused by genetic and lifestyle influences, including low intakes of folate and vitamin B6. However, prospective data relating intake of these vitamins to risk of coronary heart disease (CHD) are not available.

OBJECTIVE

To examine intakes of folate and vitamin B6 in relation to the incidence of nonfatal myocardial infarction (MI) and fatal CHD.

DESIGN

Prospective cohort study.

SETTING AND PATIENTS

In 1980, a total of 80082 women from the Nurses' Health Study with no previous history of cardiovascular disease, cancer, hypercholesterolemia, or diabetes completed a detailed food frequency questionnaire from which we derived usual intake of folate and vitamin B6.

MAIN OUTCOME MEASURE

Nonfatal MI and fatal CHD confirmed by World Health Organization criteria.

RESULTS

During 14 years of follow-up, we documented 658 incident cases of nonfatal MI and 281 cases of fatal CHD. After controlling for cardiovascular risk factors, including smoking and hypertension and intake of alcohol, fiber, vitamin E, and saturated, polyunsaturated, and trans fat, the relative risks (RRs) of CHD between extreme quintiles were 0.69 (95% confidence interval [CI], 0.55-0.87) for folate (median intake, 696 microg/d vs 158 microg/d) and 0.67 (95% CI, 0.53-0.85) for vitamin B6 (median intake, 4.6 mg/d vs 1.1 mg/d). Controlling for the same variables, the RR was 0.55 (95% CI, 0.41-0.74) among women in the highest quintile of both folate and vitamin B6 intake compared with the opposite extreme. Risk of CHD was reduced among women who regularly used multiple vitamins (RR=0.76; 95% CI, 0.65-0.90), the major source of folate and vitamin B6, and after excluding multiple vitamin users, among those with higher dietary intakes of folate and vitamin B6. In a subgroup analysis, compared with nondrinkers, the inverse association between a high-folate diet and CHD was strongest among women who consumed up to 1 alcoholic beverage per day (RR =0.69; 95% CI, 0.49-0.97) or more than 1 drink per day (RR=0.27; 95% CI, 0.13-0.58).

CONCLUSION

These results suggest that intake of folate and vitamin B6 above the current recommended dietary allowance may be important in the primary prevention of CHD among women.

Authors+Show Affiliations

Department of Epidemiology, Harvard School of Public Health, Boston, Mass 02115, USA. eric.rimm@channing.harvard.eduNo 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
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9459468

Citation

Rimm, E B., et al. "Folate and Vitamin B6 From Diet and Supplements in Relation to Risk of Coronary Heart Disease Among Women." JAMA, vol. 279, no. 5, 1998, pp. 359-64.
Rimm EB, Willett WC, Hu FB, et al. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA. 1998;279(5):359-64.
Rimm, E. B., Willett, W. C., Hu, F. B., Sampson, L., Colditz, G. A., Manson, J. E., ... Stampfer, M. J. (1998). Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA, 279(5), pp. 359-64.
Rimm EB, et al. Folate and Vitamin B6 From Diet and Supplements in Relation to Risk of Coronary Heart Disease Among Women. JAMA. 1998 Feb 4;279(5):359-64. PubMed PMID: 9459468.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. AU - Rimm,E B, AU - Willett,W C, AU - Hu,F B, AU - Sampson,L, AU - Colditz,G A, AU - Manson,J E, AU - Hennekens,C, AU - Stampfer,M J, PY - 1998/2/12/pubmed PY - 2001/8/14/medline PY - 1998/2/12/entrez SP - 359 EP - 64 JF - JAMA JO - JAMA VL - 279 IS - 5 N2 - CONTEXT: Hyperhomocysteinemia is caused by genetic and lifestyle influences, including low intakes of folate and vitamin B6. However, prospective data relating intake of these vitamins to risk of coronary heart disease (CHD) are not available. OBJECTIVE: To examine intakes of folate and vitamin B6 in relation to the incidence of nonfatal myocardial infarction (MI) and fatal CHD. DESIGN: Prospective cohort study. SETTING AND PATIENTS: In 1980, a total of 80082 women from the Nurses' Health Study with no previous history of cardiovascular disease, cancer, hypercholesterolemia, or diabetes completed a detailed food frequency questionnaire from which we derived usual intake of folate and vitamin B6. MAIN OUTCOME MEASURE: Nonfatal MI and fatal CHD confirmed by World Health Organization criteria. RESULTS: During 14 years of follow-up, we documented 658 incident cases of nonfatal MI and 281 cases of fatal CHD. After controlling for cardiovascular risk factors, including smoking and hypertension and intake of alcohol, fiber, vitamin E, and saturated, polyunsaturated, and trans fat, the relative risks (RRs) of CHD between extreme quintiles were 0.69 (95% confidence interval [CI], 0.55-0.87) for folate (median intake, 696 microg/d vs 158 microg/d) and 0.67 (95% CI, 0.53-0.85) for vitamin B6 (median intake, 4.6 mg/d vs 1.1 mg/d). Controlling for the same variables, the RR was 0.55 (95% CI, 0.41-0.74) among women in the highest quintile of both folate and vitamin B6 intake compared with the opposite extreme. Risk of CHD was reduced among women who regularly used multiple vitamins (RR=0.76; 95% CI, 0.65-0.90), the major source of folate and vitamin B6, and after excluding multiple vitamin users, among those with higher dietary intakes of folate and vitamin B6. In a subgroup analysis, compared with nondrinkers, the inverse association between a high-folate diet and CHD was strongest among women who consumed up to 1 alcoholic beverage per day (RR =0.69; 95% CI, 0.49-0.97) or more than 1 drink per day (RR=0.27; 95% CI, 0.13-0.58). CONCLUSION: These results suggest that intake of folate and vitamin B6 above the current recommended dietary allowance may be important in the primary prevention of CHD among women. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/9459468/Folate_and_vitamin_B6_from_diet_and_supplements_in_relation_to_risk_of_coronary_heart_disease_among_women_ L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/279/pg/359 DB - PRIME DP - Unbound Medicine ER -