Dietary Folate May Reduce Stroke Risk

Journal Watch. 2002;1(4) 

Summary

Research has shown a link between higher blood levels of folic acid and fewer adverse cardiovascular events, including stroke (e.g., JW Cardiology Feb 16 2001), but prospective studies on dietary intake of folic acid and stroke risk are lacking. These researchers analyzed prospective questionnaire data about diet from 9764 participants (age range, 25-74) who were free of cardiovascular disease (CVD) upon enrollment in the NHANES I Epidemiologic Follow-Up Study. The primary endpoints were stroke and CVD events, as documented by death certificate or ICD-9 discharge for stroke or CVD from a hospital or nursing home.

During follow-up (mean, 19 years), 926 incident strokes and 3758 CVD events occurred. In a multivariate analysis, participants in the highest quartile of folate intake (>300.6 µg/day) were significantly less likely to suffer stroke (relative risk, 0.80) or CVD events (RR, 0.86) than were participants in the lowest quartile (<136.0 µg/day).

These prospective data support the case that diets high in folate reduce CVD events. Although, as an editorialist notes, we have not proved causality and await results from several randomized controlled trials, the present and other findings argue for increasing daily folate intake to 300-400 µg/day through consumption of fruits and vegetables that are high in folate or through multivitamin use.

— JoAnne M. Foody, MD

Bazzano LA et al. Dietary intake of folate and risk of stroke in US men and women: NHANES I Epidemiologic Follow-Up Study. Stroke 2002 May; 33:1183-8.

Kasner SE. Folate and the risk of stroke: Fortify first and ask questions later? Stroke 2002 May; 33:1188-9.

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