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Would Folic Acid Prevent Heart Disease?
 

Folic acid is a water-soluble B vitamin. It helps our body make healthy new cells, so it is something that is required by everybody. A person who lacks of dietary folic acid could lead to folate deficiency (FD), which can result in many health problems, including miscarriage and some birth defects, colon cancer or cervical cancer, heart disease and stroke.

Low level of folate could lead to accumulation of homocysteine, an amino acid created by the body, usually as a byproduct of digesting consumed meat. High level of homocysteine could damage coronary arteries or make it easier for blood clot. Every year, about 13,500 people died of coronary artery disease due to FD effect. There is evidence showing an elevated homocysteine level is an independent risk factor for heart disease and stroke.

If a person does not get enough folic acid from the foods consumed, he or she could take it as a dietary supplement. 1 in 3 adults in the United States and 1 in 4 in the United Kingdom are believed to take folic acid daily, mostly as part of a multivitamin. In the United States, foods are fortified with folic acid to prevent neural tube birth defects.

While adequate concentrations of folate, Vitamin B12, or Vitamin B6 might reduce the circulating level of homocysteine, does it mean that the rate of cardiovascular events could be reduced with the help of folic acid supplements?

In a paper appeared in the 11 October 2010’s issue of Archives of Internal Medicine, one of the JAMA/Archives journals, researchers from the University of Oxford in the United Kingdom, after analyzing 8 large trials, argued that the rate of cardiovascular events does not seem to be reduced with the use of folic acid supplement.

According to the researchers, trials with B vitamin supplements, particularly folic acid, have seen reduced levels of homocysteine and lower risk of cardiovascular disease among patients with homocystinuria. Homocystinuria is an inherited disorder that affects the metabolism of methionine, which is a protein-based amino acid that breaks down fat, and is the primary source of sulfur in the body.

However, other trials involving people without homocystinuria have been inconclusive. In other words, for the general population, the effects of taking folic acid supplements on cardiovascular disease to lower homocysteine levels are somewhat uncertain.

In 2004, the researchers pooled results of 8 large randomized, placebo-controlled trials of folic acid supplementation involving nearly 37,485 participants at increased risk of cardiovascular disease. The last trial completed in 2009.

Among the participants, 18,723 were randomly assigned to take a daily dose of folic acid ranging from 0.8 to 40 milligrams per day, while the other 18,762 took placebo or an equivalently small dose of folic acid. The doses of folic acid used in all the trials exceeded those required for near-maximal reduction in homocysteine levels.

The findings showed that 9,326 participants had a major vascular event during the treatment period; 3,010 developed cancer; and 5,125 died.

Overall, those in the active folic acid groups had an average 25 percent cut in homocysteine levels. Over a median follow-up of 5 years, there was only little difference between the active folic acid and placebo participants' rates of major vascular events. Similarly, the difference between active folic acid and placebo in the rates of major coronary events and stroke was not large either.

Meanwhile, no significant differences was found between active folic acid and placebo for overall vascular mortality, overall cancer incidence, cancer mortality, or deaths from all causes, either during the whole scheduled treatment period or during the later period of it.

Based on the results, the researchers concluded that dietary supplementation with folic acid to lower homocysteine levels had no significant effects within 5 years on cardiovascular events or on overall cancer or mortality in the populations studied. They further pointed out that the trials also found no evidence of benefit with treatment continued for more than 5 years.

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