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Folic acid and heart disease

HYATTSVILLE, MARYLAND. High homocysteine levels are associated with an increased risk of heart disease. High homocysteine levels have also been linked to a relative folic acid deficiency. Researchers at the Centers for Disease Control and Prevention now report that low blood levels of folic acid are associated with a substantially increased risk of dying from cardiovascular disease. Their study involved 689 adults aged between 30 and 75 years who were free of heart disease at the start of the study in 1976-1980. After 12 to 16 years of follow-up 122 of the participants without diabetes had died - 49 of them from heart disease. Among the participants with diabetes, 52 in all, 25 died - 12 of them from heart disease.

In the non-diabetic group there was a clear association between blood levels of folate and death from heart disease. The participants with folate levels below 10 nmol/L had a 2.64 times higher age and sex adjusted risk of dying from cardiovascular disease than did the participants with levels above 16.8 nmol/L. Even when adjusting for other risk factors (education level, race, cigarette smoking, alcohol consumption, cholesterol levels, blood pressure, and body mass index) the death rate among the participants with low folate status was still 2.28 times higher than among the people with higher levels. The observations made in the non-diabetic group tended to parallel those in the diabetes group, but because of the small sample size in the diabetes group the observed trends were not statistically significant.

The researchers conclude that at least a third of the participants had folate levels at baseline (1976-1980) so low that they would be in the high-risk category for dying from cardiovascular disease. They urge further work to determine if recent efforts to fortify the US food supply with folic acid are sufficient to decrease the proportion of the population at risk for heart disease because of insufficient folate levels.
Loria, Catherine M., et al. Serum folate and cardiovascular disease mortality among US men and women. Archives of Internal Medicine, Vol. 160, November 27, 2000, pp. 3258-62

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