Folate and risk of cardiovascular disease

doi:10.1136/bmj.326.7397.1035/a

BMJ 2003;326:1035 ( 10 May )

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Folate and risk of cardiovascular disease

Study results were misinterpreted

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Study results were misinterpreted

The first 150 words of the full text of this article appear below.

EDITOR $---$ Hung et al conclude that their cohort study on serum folate and coronary heart disease provides evidence against theview that folic acid prevents coronary heart disease.¹ We disagreeand believe they have misinterpreted theirresults.

A meta-analysis of studies on homocysteine and cardiovascular disease, supported by others,^2-4 together with randomised trialevidence on folic acid dose and serum homocysteine reduction,shows that the maximal homocysteine lowering effect of folic acidoccurs at a dose of about 0.8 mg/day (which increases serum folateby 20 µg/l).⁵ This homocysteine reduction lowers the risk ofcoronary heart disease by about 16%. The difference in averageserum folate between the highest and the lowest folate group inthe cohort study of Hung et al was about 7 µg/l, since the medianof the highest folate group was about 8 µg/l (the 93rd centilewas stated as 9 µg/l, so the 85th centile must have been less. . . [Full text of this article]

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Folate and vitamin B-12 and risk of fatal cardiovascular disease: cohort study from Busselton, Western Australia: Joseph Hung, John P Beilby, Matthew W Knuiman, and Mark Divitini
BMJ 2003 326: 131. [Abstract] [Full Text] [PDF]

Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis: David S Wald, Malcolm Law, and Joan K Morris
BMJ 2002 325: 1202-1206. [Abstract] [Full Text] [PDF]