In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 37, No. 2 ( 2006-02), p. 547-549
Abstract:
Background and Purpose— A higher plasma concentration of total homocysteine (tHcy) is associated with a greater risk of cardiovascular events. Previous studies, largely in younger individuals, have shown that B vitamins lowered tHcy by substantial amounts and that this effect is greater in people with higher tHcy and lower folate levels. Methods— We undertook a 2-year, double-blind, placebo-controlled, randomized trial in 299 men aged ≥75 years, comparing treatment with a daily tablet containing 2 mg of folate, 25 mg of B 6 , and 400 μg of B 12 or placebo. The study groups were balanced regarding age (mean±SD, 78.9±2.8 years), B vitamins, and tHcy at baseline. Results— Among the 13% with B 12 deficiency, the difference in mean changes in treatment and control groups for tHcy was 6.74 μmol/L (95% CI, 3.94 to 9.55 μmol/L) compared with 2.88 μmol/L (95% CI, 0.07 to 5.69 μmol/L) for all others. Among the 20% with hyperhomocysteinaemia, the difference between mean changes in treatment and control groups for men with high plasma tHcy compared with the rest of the group was 2.8 μmol/L (95% CI, 0.6 to 4.9 μmol/L). Baseline vitamin B 12 , serum folate, and tHcy were significantly associated with changes in plasma tHcy at follow-up ( r =0.252, r =0.522, and r =−0.903, respectively; P =0.003, 〈 0.001, and 〈 0.001, respectively) in the vitamin group. Conclusions— The tHcy-lowering effect of B vitamins was maximal in those who had low B 12 or high tHcy levels. Community-dwelling older men, who are likely to be deficient in B 12 or have hyperhomocysteinemia, may be most likely to benefit from treatment with B vitamins.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/01.STR.0000198815.07315.68
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2006
detail.hit.zdb_id:
1467823-8
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