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Efficacy of folic acid supplementation in stroke prevention: a meta-analysis.
MedLine Citation:
PMID:  17544768     Owner:  NLM     Status:  MEDLINE    
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.
Xiaobin Wang; Xianhui Qin; Hakan Demirtas; Jianping Li; Guangyun Mao; Yong Huo; Ningling Sun; Lisheng Liu; Xiping Xu
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  Lancet     Volume:  369     ISSN:  1474-547X     ISO Abbreviation:  Lancet     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-04     Completed Date:  2007-06-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  1876-82     Citation Subset:  AIM; IM    
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 60614-3394, USA.
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MeSH Terms
Folic Acid / therapeutic use*
Homocysteine / blood*
Middle Aged
Randomized Controlled Trials as Topic
Stroke / prevention & control*
Vitamin B Complex / therapeutic use*
Reg. No./Substance:
12001-76-2/Vitamin B Complex; 454-28-4/Homocysteine; 59-30-3/Folic Acid
Comment In:
Lancet. 2007 Aug 25;370(9588):651; author reply 651   [PMID:  17720005 ]
J Fam Pract. 2007 Sep;56(9):705   [PMID:  17802643 ]
Lancet. 2007 Jun 2;369(9576):1841-2   [PMID:  17544750 ]

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