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Elevated blood homocysteine levels are associated with increased cardiovascular risk, but in randomized trials, homocysteine reduction has failed to lower overall risk for cardiovascular disease. Some studies, however, have suggested that folic acid supplementation may reduce the risk for stroke.
Researchers combined the results of eight randomized trials involving more than 16,000 patients, some of whom received folic acid supplementation (with or without other B vitamins) for 24 to 72 months, while controls received either placebo, usual care, or a lower dose of folic acid. All but one of these trials were included in an earlier meta-analysis that showed no effect of folic acid supplementation on cardiovascular endpoints in patients with p…