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|B Vitamins May Not Reduce Cardiovascular Events|
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In a large clinical trial involving patients with coronary artery disease, use of B vitamins was not effective for preventing death or cardiovascular events, according to a study published in the August 20, 2008 issue of JAMA.
“Observational studies have demonstrated that the concentration of total homocysteine in blood is associated with risk of coronary artery disease and stroke,” the authors provide as background information. Plasma total homocysteine levels can be lowered by oral administration of folic acid and vitamin B12. In this study, the authors’ objective was “to evaluate the effects of homocysteine-lowering treatment with folic acid plus vitamin B12 on mortality and cardiovascular events.”
Marta Ebbing, M.D. of Haukeland University Hospital, Bergen, Norway and colleagues, conducted a randomized controlled study with 3,096 patients in two Norwegian hospitals between 1999 – 2006. Patients were randomly assigned to one of four groups receiving a daily oral dose of one of the following treatments: folic acid, 0.8mg, plus vitamin B12 , 0.4mg, plus vitamin B6 , 40mg (n= 772); folic acid plus vitamin B12 (n = 772); vitamin B6 alone (n = 772); or placebo (n = 780). Patients were scheduled for follow-up visits with an interview, clinical examination, and blood sampling at one month, one year, and at a final study visit. The main outcome measure (primary end point) was a composite of all-cause death, nonfatal acute myocardial infarction (heart attack), acute hospitalization for unstable angina pectoris, and nonfatal thromboembolic stroke.
The study was stopped early because of concerns among the participants about preliminary results from another similar Norwegian study suggesting no benefits from the treatment and an increased risk of cancer from the B vitamins.
“Mean (average) plasma total homocysteine concentration was reduced by 30 percent after 1 year of treatment in the groups receiving folic acid and vitamin B12,” the authors report. “During a median (midpoint) 38 months of follow-up, the primary end point was experienced by a total of 422 participants (13.7 percent): 219 participants (14.2 percent) receiving folic acid/vitamin B12 vs. 203 (13.1 percent) not receiving such treatment and 200 participants (13.0 percent) receiving vitamin B6 vs. 222 (14.3 percent) not receiving vitamin B6.”
“… we could not
detect any preventive effect of intervention with folic acid plus
vitamin B12 or with vitamin B6 on mortality or major cardiovascular
events among patients with stable coronary artery disease undergoing
intensive conventional treatment. We found a numerically lower
incidence of stroke and higher incidence of cancer in the groups
receiving folic acid, but these observations were not statistically
significant,” the authors conclude. “Our findings do not support the
use of B vitamins as secondary prevention in patients with coronary
About Coronary Artery Disease (CAD)
Coronary artery disease (CAD), also called coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart.
CAD is the leading cause of death in the United States for men and women. According to the American Heart Association, more than 15 million people have some form of the condition.
Coronary artery disease is caused by any problem with the coronary arteries that keeps the heart from getting enough oxygen- and nutrient-rich blood. The most common cause is atherosclerosis which occurs when fatty material and a substance called plaque builds up on the walls of your arteries. This causes them to get narrow. As the coronary arteries narrow, blood flow to the heart can slow down or stop, causing chest pain (stable angina), shortness of breath, heart attack, and other symptoms. Lack of sufficient blood is called ischemia, so coronary artery disease is sometimes called ischemic heart disease.
Risks for developing CAD include:
Coronary Artery Disease Symptoms
Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms. Symptoms may include:
Other symptoms may include:
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