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Folic acid helps heart disease patients

HALIFAX, CANADA. Several studies have concluded that high homocysteine levels are associated with coronary artery disease (CAD). It is believed that homocysteine promotes atherosclerosis through increased oxidative stress and by "encouraging" dysfunction of the lining of the arteries (endothelial dysfunction). It is generally accepted that folic acid supplementation will lower homocysteine levels, but whether folic acid supplementation will also reduce the endothelial dysfunction responsible for the initiation and progression of atherosclerosis is less certain.

Medical researchers at the Queen Elizabeth II Health Sciences Centre now report that supplementation with 5 mg/day of folic acid significantly decreases endothelial dysfunction. The extent of endothelial dysfunction is determined by measuring the blood flow through the brachial artery in the arm (flow-mediated dilation or FMD). The clinical trial included 75 patients with CAD. The patients were randomized into three groups. One group took 5 mg of folic acid daily for four months; the second group took 5 mg of folic acid plus 2000 mg of vitamin C plus 800 IU of vitamin E per day; the third group was given a placebo. At the end of the trial patients in the folic acid group had increased their blood plasma level of folate by 475 per cent (from 14 nmol/L to 80 nmol/L) and decreased their homocysteine level by about 11 per cent. FMD improved significantly as well (from 3.2 to 5.2 per cent). Patients in the folic acid plus antioxidant group increased their folate level by 438 per cent, reduced homocysteine by 9 per cent, and improved FMD from 2.6 to 4.0 per cent. The researchers point out that the FMD improvement seen in the folic acid supplemented groups is similar to that seen with statin drugs and ACE inhibitors. They conclude that four months of folic acid supplementation is safe and significantly reduces endothelial dysfunction in patients with established coronary atherosclerosis. [61 references]
Title, Lawrence M., et al. Effect of folic acid and antioxidant vitamins on endothelial dysfunction in patients with coronary artery disease. Journal of the American College of Cardiology, Vol. 36, September 2000, pp. 758-65

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