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Efficacy of folic acid supplementation in stroke prevention: new insight from a meta-analysis.
MedLine Citation:
PMID:  22607506     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims:  There are growing data and a continuing controversy over the efficacy of folic acid supplementation in stroke prevention. We conducted a meta-analysis based on relevant, up-to-date published randomised trials to further examine this issue. Methods:  Relative risk (RR) was used to measure the effect of folic acid supplementation on risk of stroke with a fixed-effects model. Results:  Overall, folic acid supplementation reduced the risk of stroke by 8% (n = 55,764; RR: 0.92; 95% CI: 0.86-1.00, p = 0.038). In the 10 trials with no or partial folic acid fortification (n = 43,426), the risk of stroke was reduced by 11% (0.89; 0.82-0.97, p = 0.010). Within these trials, a greater beneficial effect was observed among trials with a lower percent use of statins [≤ 80% (median); 0.77; 0.64-0.92, p = 0.005], and a meta-regression analysis also suggested a positive dose-response relationship between percent use of statins and log-RR for stroke associated with folic acid supplementation (p = 0.013). A daily dose of 0.4-0.8mg folic acid appeared to be adequate for stroke prevention in comparison with larger doses. In the remaining five trials conducted in populations with folic acid fortification (n = 12,338), folic acid supplementation had no effect on stroke risk (1.03; 0.88-1.21, p = 0.69). Conclusions:  Our analysis indicated that folic acid supplementation is effective in stroke prevention in populations with no or partial folic acid fortification. In addition, a greater beneficial effect was observed among trials with a lower percent use of statins. Our findings underscore the importance of identifying target populations that can particularly benefit from folic acid therapy.
Authors:
Y Huo; X Qin; J Wang; N Sun; Q Zeng; X Xu; L Liu; X Xu; X Wang
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  International journal of clinical practice     Volume:  66     ISSN:  1742-1241     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-5-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9712381     Medline TA:  Int J Clin Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  544-551     Citation Subset:  -    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
Department of Cardiology, Peking University First Hospital, Beijing, China Institute of Biomedicine, Anhui Medical University, Hefei, China Centre for Epidemiological Studies and Clinical Trials, Ruijin Hospital, The Shanghai Institute of Hypertension, Shanghai Jiaotong University School of Medicine, Shanghai, China Department of Cardiology, Beijing University Peoples Hospital, Beijing, China Health Examination Center, Chinese People's Liberation Army General Hospital, Beijing, China Guangdong Institute of Nephrology, Southern Medical University, Guangzhou, China Division of Hypertension, Fu-Wai Hospital, and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, China Center on the Childhood Origins of Disease Johns Hopkins University Bloomberg School of Public Health Department of Population, Family and Reproductive Health, Baltimore, USA.
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