Consider The Evidence: Med/Peds Journal Roundup

April 13, 2006

B12 & Folic Acid, lower homocysteine but not cardiovascular risk

Filed under: CVD, homocysteine, NEJM, stroke — medblog @ 11:11 pm

NEJM 4/13 – After the correlation between high homocysteine levels and disease such as stroke and MI was discovered, there was a flurry of work looking at the connection. The hope was that the effect was causal, and the simple use of B vitamins would lower homocysteine levels and reduce mortality.

The HOPE-2 investigators published an article exploring whether folic acid and B12 supplementation would lower the risk of cardiovascular events via reduction of homocysteine levels. This was a large study including over 5000 patients. Although the treatment group had significantly lower homocysteinie levels, there were no significant differences between the groups in the rates of death from cardiovascular causes or myocardial infarction.

After the failure of HOPE-TOO to show improved outcomes with vitamin E, this is the second vitamin supplementation study that has not shown a benefit. I guess we will have to wait for the next one to come along….

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