Randomized clinical trial of folate supplementation in patients with peripheral arterial disease

✍ Scribed by N. Khandanpour; M. P. Armon; B. Jennings; P. M. Finglas; G. Willis; A. Clark; F. J. Meyer

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 141 KB
• Volume: 96
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.6670

✦ Synopsis

Abstract

Background

The aim was to determine whether folate supplementation improved arterial function in patients with peripheral arterial disease (PAD).

Methods

Individuals with PAD were randomly assigned to receive 400 µg folic acid (45 patients) or 5-methyltetrahydrofolate (5-MTHF) (48) daily, or placebo (40) for 16 weeks. Primary endpoints were changes in plasma total homocysteine (tHcy), ankle : brachial pressure index (ABPI) and pulse wave velocity (PWV). Secondary outcomes were changes in plasma inflammatory markers.

Results

Plasma tHcy was significantly reduced in folic acid and 5-MTHF groups compared with controls: median difference: − 2·12 (95 per cent confidence interval − 3·70 to − 0·75) µmol/l (P = 0·002) and − 2·07 (−3·48 to − 0·54) µmol/l (P = 0·007) respectively. ABPI improved significantly: median difference 0·07 (0·04 to 0·11) (P < 0·001) and 0·05 (0·01 to 0·10) (P = 0·009) respectively. Brachial–knee PWV (bk-PWV) decreased significantly in individuals receiving 5-MTHF and tended to be reduced in those taking folic acid compared with controls: median difference: − 1·10 (−2·20 to − 0·20) m/s (P = 0·011) and − 0·90 (−2·10 to 0·00) m/s (P = 0·051) respectively. Plasma levels of inflammatory markers were not affected.

Conclusion

Folate administration reduced plasma homocysteine, and slightly improved ABPI and bk-PWV.