Lowering homocysteine with folic acid doesn’t reduce morbidity or mortality

January 01, 0001

Lowering homocysteine with folic acid doesn’t reduce morbidity or mortality

In this meta-analysis by UK authors individual participant data (n=37,485) were obtained from 8 large, randomized, placebo-controlled trials of folic acid supplementation to reduce cardiovascular risk in, 485 individuals at increased risk. The analyses involved intention-to-treat comparisons of first events during the scheduled treatment period.

They found: "There were 9326 major vascular events (3990 major coronary events, 1528 strokes, and 5068 revascularizations), 3010 cancers, and 5125 deaths. Folic acid allocation yielded an average 25% reduction in homocysteine levels. During a median follow-up of 5 years, folic acid allocation had no significant effects on vascular outcomes, with rate ratios of 1.01 for major vascular events, 1.03 for major coronary events, and 0.96 for stroke. Likewise, there were no significant effects on vascular outcomes in any of the subgroups studied or on overall vascular mortality. There was no significant effect on the rate ratios for overall cancer incidence, cancer mortality or all-cause mortality during the whole scheduled treatment period or during the later years of it."

The authors concluded: "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."

Lowering homocysteine with folic acid is not effective.

For the full abstract, click here.

Arch Intern Med 170(18):1622-1631, 11 October 2010
© 2010 to the American Medical Association
Effects of Lowering Homocysteine Levels With B Vitamins on Cardiovascular Disease, Cancer, and Cause-Specific Mortality-Meta-analysis of 8 Randomized Trials Involving 37,485 Individuals. Robert Clarke, Jim Halsey, Sarah Lewington, et al. Correspondence to Robert Clark: [email protected]

Category: K. Circulatory, T. Endocrine/Metabolic/Nutritional. Keywords: homocysteine, folic acid, coronary artery disease, stroke, death, cancer, meta-analysis of randomized controlled trials, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 26 October 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.