Study: Folic Acid Therapy Significantly Lowered Stroke Risk

The cardiovascular benefits of folic acid, otherwise known as folate, were documented in the study. It’s true that you can certainly take a pill to help get more folates, but the best way is with green leafy vegetables, citrus fruits and beans. Grain-based foods also help, like rice, past and cornmeal. “Fruits and vegetables are important sources of folate in the diet, and they also bring lots of other benefits, such as potassium and phytonutrients, that also help lower cardiovascular disease,” concludes Dr. Walter Willett, professor of epidemiology and nutrition at Harvard T.H. Chan School of Public Health, via the Harvard Health Blog.

Folic Acid May Help Prevent Stroke

Folic acid supplementation appears to lower stroke risk in hypertensive patients with low blood folate levels.

In the China Stroke Primary Prevention Trial (CSPPT), which included more than 20,000 adults with high blood pressure but no history of stroke or myocardial infarction, folic acid therapy appeared to significantly lower stroke risk when given with the blood pressure drug enalapril (Vasotec), compared with enalapril alone.

Results from the randomized, double-blind trial were published online this week in the Journal of the American Medical Association.

The study included adults with hypertension whose average age was 60 at study entry. Participants took either the enalapril-folic acid single pill (n=10,348) or enalapril alone (10,354) daily during the trial. More than half (57%) also took other antihypertension medications.

The original plan was to treat patients for 5 years, but the findings were so robust that the trial was terminated after 4.5 years.

Many previous trials examining folic acid supplementation and cardiovascular risk have shown little or no protective effect for the B vitamin, but Willett and Stampfer noted than these trials had design flaws and other limitations that the “carefully designed and executed” CSPPT trial managed to avoid. They further noted that the findings may actually underestimate the true effect of folic acid supplementation on stroke risk in adults with low blood folate levels.

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Selected food sources of folate
Food Micrograms (mcg)
Breakfast cereal, fortified with 25% of the DV, 3/4 cup 100
Spinach, frozen, boiled, ½ cup 131
Great Northern beans, boiled, ½ cup 90
Asparagus, boiled, 4 spears 89
Broccoli, chopped, frozen, cooked, ½ cup 84
Rice, white, long-grain, parboiled, enriched, cooked, ½ cup 77
Spinach, raw, 1 cup 58
Green peas, frozen, boiled, ½ cup 50
Orange, 1 medium 48
Egg noodles, enriched, cooked, ½ cup 50
Mango, raw, ½ cup 35
Source: USDA National Nutrient Database for Standard Reference

More On Folate

Folate is found naturally in an array of foods but is found in high dosages from leafy vegetables, grains, pastas, lentils, beans, asparagus, spinach, broccoli, peas, and citrus fruits, according to a recent food source review published by the Dieticians of Canada. Folate-fortified foods are important for certain groups who aren’t exposed to enough folate, such as those on gluten-free diets and Americans in the southwest of the country who frequently use corn flour instead of grain products.

High blood pressure, also known as hypertension, affects 80 million U.S. adults, according to the American Heart Association. The frightening part is the disease can develop without any symptoms, but can have life-threatening consequences if not treated in time. Over time, the force of the blood flow continues to push too high against the artery walls. The tissue that makes up those walls become too stretched and that’s when damage occurs.

“Fruits and vegetables are important sources of folate in the diet, and they also bring lots of other benefits, such as potassium and phytonutrients, that also help lower cardiovascular disease,” said Dr. Walter Willett, professor of epidemiology and nutrition from Harvard T.H. Chan School of Public Health, who co-authored an editorial about the new study. “It still makes sense for most people to take a multivitamin, multimineral supplement every day,”

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