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Lancet. 2007 Jun 2;369(9576):1876-1882. doi: 10.1016/S0140-6736(07)60854-X.

Efficacy of folic acid supplementation in stroke prevention: a meta-analysis.

Author information

1
Mary Ann and J Milburn Smith Child Health Research Program, Children's Memorial Hospital and Children's Memorial Research Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address: xbwang@childrensmemorial.org.
2
Institute for Biomedicine, Anhui Medical University, Hefei, China.
3
Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL, USA.
4
Department of Cardiology, First Hospital of Peking University, Beijing, China.
5
Department of Cardiology, People's Hospital of Peking University, Beijing, China.
6
Division of Hypertension, Fu-Wai Hospital, Beijing, China; Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, China.

Abstract

BACKGROUND:

The efficacy of treatments that lower homocysteine concentrations in reducing the risk of cardiovascular disease remains controversial. Our aim was to do a meta-analysis of relevant randomised trials to assess the efficacy of folic acid supplementation in the prevention of stroke.

METHODS:

We collected data from eight randomised trials of folic acid that had stroke reported as one of the endpoints. Relative risk (RR) was used as a measure of the effect of folic acid supplementation on the risk of stroke with a random effect model. The analysis was further stratified by factors that could affect the treatment effects.

FINDINGS:

Folic acid supplementation significantly reduced the risk of stroke by 18% (RR 0.82, 95% CI 0.68-1.00; p=0.045). In the stratified analyses, a greater beneficial effect was seen in those trials with a treatment duration of more than 36 months (0.71, 0.57-0.87; p=0.001), a decrease in the concentration of homocysteine of more than 20% (0.77, 0.63-0.94; p=0.012), no fortification or partly fortified grain (0.75, 0.62-0.91; p=0.003), and no history of stroke (0.75, 0.62-0.90; p=0.002). In the corresponding comparison groups, the estimated RRs were attenuated and insignificant.

INTERPRETATION:

Our findings indicate that folic acid supplementation can effectively reduce the risk of stroke in primary prevention.

PMID:
17544768
DOI:
10.1016/S0140-6736(07)60854-X
[Indexed for MEDLINE]

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