CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

March 16th, 2015

Folic Acid Supplementation Helps Reduce Stroke Risk in Certain Populations

Supplementation with folic acid might help prevent stroke in adults with hypertension — particularly in those with low serum folate levels — according to a study presented on Sunday at the American College of Cardiology conference in San Diego and published in JAMA.

Over 20,000 Chinese adults with hypertension and without histories of MI or stroke were randomized to receive daily enalapril either alone or combined with folic acid (0.8 mg). During roughly 4.5 years’ treatment, first strokes occurred significantly less often with enalapril plus folic acid than with enalapril alone (2.7% vs. 3.4%). The benefit was greatest among participants with the lowest baseline folate levels.

Editorialists note that previous trials showing no benefit of folic acid were conducted in populations with higher baseline folate levels (for example, in the U.S., where grains are fortified with folic acid). They conclude: “This study seems to support fortification programs where feasible, and supplementation should be considered where fortification will take more time to implement.”

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