Coronary heart disease folic acid

Coronary heart disease Folic acid Cobalamin (vitamin B12) Pyridoxine (vitamin Be) Homocysteine reduction MA of RCTs supplementation in patients does not affect risk of a recurrent event Clarke et al. (2010)... 

Folacin has recently been implicated in a number of nonvitamin functions, including roles in various types of cancer, coronary heart disease, and the prevention of birth defects, such as neural tube abnormalities (109,121,131-144). Investigations into these functions are ongoing and have generated controversy concerning the exact nature of the nonvitamin functions, human nutritional requirements for folacin, and the wisdom of food fortification or supplementation of selected population groups with pharmacological doses of folic acid (131,132,145-150). 

Fenofibrate and bezafibrate can cause hyperhomocystei-nemia, which is a risk factor for coronary heart disease. The authors of a review suggested using gemfibrozil instead or adding vitamin B12 and folic acid (12). 

The identification of hyperhomocysteinemia as an independent risk factor in atherosclerosis and coronary heart disease (Section 10.3.4.2) has led to suggestions that intakes of vitamin Be higher than are currently considered adequate to meet requirements may be desirable. Homocysteine is an intermediate in methionine metabolism and may undergo one of two metabolic fates, as shown in Figure 9.5 remethylation to methionine (a reaction that is dependent on vitamin B12 and folic acid) or onward metabolism leading to the synthesis of cysteine (trans-sulfuration). Therefore, intakes of folate, vitamin B12, and/or vitamin Be may affect homocysteine metabolism. 

M. M. Malinow, P. B. Duell, D. L. Hess, et al Reduction of plasma homocysteine levels by breakfast cereal fortified with folic acid in patients with coronary heart disease. The New England Journal of Medicine 338, 1009 (1998). 

Randomized controlled trials tested the effect of folic acid on recurrence of coronary heart disease and stroke, but did not show a protective effect of folic acid. 

B vitamins. Among the 13 vitamins, B vitamins are eight water-soluble vitamins (vitamin Bp thiamine vitamin B2 riboflavin vitamin B3 niacin vitamin B5 pantothenic acid vitamin Bg pyridoxine, pyridoxal or pyridoxamine vitamin B7 biotin vitamin B9 folic acid or folate and vitamin B cyanoco-balamin). Folate and vitamins Bg and B12 have joint effects on homocysteine. Cardiovascular disease. Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels and includes coronary heart disease, cerebrovascular disease, peripheral arterial disease, rheumatic heart disease, congenital heart disease (malformations of heart structure existing at birth) and deep vein thrombosis and pulmonary embolism. 

The comparisons were intention-to-treat analyses of first events during the scheduled treatment period in all participants allocated to folic acid-based B vitamins or control (irrespective of any other treatment allocated factorially). The main outcomes were coronary heart disease events, stroke, cancer and allcause mortality. Coronary heart disease events were defined as the first occurrence of non-fatal myocardial infarction or coronary death although for several trials the definition of coronary events was restricted to fatal or non-fatal myocardial infarction. Stroke was defined as the first occurrence of either ischemic or hemorrhagic or unspecified strokes. Cancer was defined as any cancer, excluding non-melanoma skin cancers. 

See also Antioxidants Diet and Antioxidant Defense Observationai Studies Intervention Studies. Coronary Heart Disease Lipid Theory. Dietary Fiber Role in Nutritional Management of Disease. Fatty Acids Monounsaturated Omega-3 Polyunsaturated Omega-6 Polyunsaturated Saturated. Fish. Folic Acid. Potassium. Sodium Physiology Salt Intake and Health. Vegetarian Diets. 

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