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Review
. 2007 Jun 2;369(9576):1876-1882.
doi: 10.1016/S0140-6736(07)60854-X.

Efficacy of folic acid supplementation in stroke prevention: a meta-analysis

Xiaobin Wang  1 , Xianhui Qin  2 , Hakan Demirtas  3 , Jianping Li  4 , Guangyun Mao  2 , Yong Huo  4 , Ningling Sun  5 , Lisheng Liu  6 , Xiping Xu  3
Affiliations
Review

Efficacy of folic acid supplementation in stroke prevention: a meta-analysis

Xiaobin Wang et al. Lancet. .

Abstract

Background: The efficacy of treatments that lower homocysteine concentrations in reducing the risk of cardiovascular disease remains controversial. Our aim was to do a meta-analysis of relevant randomised trials to assess the efficacy of folic acid supplementation in the prevention of stroke.

Methods: We collected data from eight randomised trials of folic acid that had stroke reported as one of the endpoints. Relative risk (RR) was used as a measure of the effect of folic acid supplementation on the risk of stroke with a random effect model. The analysis was further stratified by factors that could affect the treatment effects.

Findings: Folic acid supplementation significantly reduced the risk of stroke by 18% (RR 0.82, 95% CI 0.68-1.00; p=0.045). In the stratified analyses, a greater beneficial effect was seen in those trials with a treatment duration of more than 36 months (0.71, 0.57-0.87; p=0.001), a decrease in the concentration of homocysteine of more than 20% (0.77, 0.63-0.94; p=0.012), no fortification or partly fortified grain (0.75, 0.62-0.91; p=0.003), and no history of stroke (0.75, 0.62-0.90; p=0.002). In the corresponding comparison groups, the estimated RRs were attenuated and insignificant.

Interpretation: Our findings indicate that folic acid supplementation can effectively reduce the risk of stroke in primary prevention.

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Comment in

  • Lowering homocysteine for stroke prevention.
    Carlsson CM. Carlsson CM. Lancet. 2007 Jun 2;369(9576):1841-1842. doi: 10.1016/S0140-6736(07)60830-7. Lancet. 2007. PMID: 17544750 No abstract available.
  • Folic acid for stroke prevention.
    Sepe V, Adamo G, Giuliano MG, Libetta C, Dal Canton A. Sepe V, et al. Lancet. 2007 Aug 25;370(9588):651; author reply 651. doi: 10.1016/S0140-6736(07)61328-2. Lancet. 2007. PMID: 17720005 No abstract available.
  • Folate prevents stroke?
    [No authors listed] [No authors listed] J Fam Pract. 2007 Sep;56(9):705. J Fam Pract. 2007. PMID: 17802643 No abstract available.

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