Folic Acid Supplementation Lowers Risk for First Stroke in Adults with Hypertension

Whether folic acid supplementation is valuable for primary prevention of strokes and other cardiovascular diseases is unclear, perhaps because study participants have widely varying baseline levels of serum folic acid. In this Chinese trial, 21,000 adults (mean age, 60) with hypertension and without known cardiovascular disease received daily enalapril (10 mg) and additionally were randomized to receive daily folic acid supplementation (0.8 mg) or placebo. Participants were stratified by genotype (CC, CT, or TT) of the methylenetetrahydrofolate reductase gene, which regulates folate metabolism. Median baseline serum folic acid levels ranged from 6.5 ng/mL (TT) to 9.0 ng/mL (CC) and increased by an average of 11 ng/mL with supplementation.

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