Why Folic Acid May Prevent a First Heart Attack but Not a Second One

by Health News

In a recent report published by the American Heart Association (AHA) journal, it showed an estimated 82,600,000 American adults have one or more types of cardiovascular disease. In short that means that one in three adults have precursors to suffering a heart attack. It is a worrying trend that the AHA, among other health groups, is keen to address.
In recently commissioned research by the Wolfson Institute of Preventative Medicine at Barts Hospital and the London School of Medicine and Dentistry, the clinical trials on folic acid threw up some surprising results that for a time had professionals mystified. Although in theory the folic acid should have considerably lowered the risk of heart attacks, it appeared to have very little effect, particularly in those who had already suffered a heart attack. The trials in question included 75 epidemiological studies involving about 50,000 participants and clinical trials involving about 40,000 participants.

How Folic Acid Works
Folic acid is a B vitamin which is known to lower homocysteine in the blood, among other benefits. It is commonly known as folate and is found in fruit and vegetables. Homocysteine is an amino acid that can be dangerous at high levels. Folic acid has been shown in previous large population studies to help reduce heart attacks by preventing platelets sticking together and the prevention of blood clotting.

Why Trials on Folic Acid Failed to Lower the Risk of Heart Attack
Aspirin has the same effect on the blood as folic acid. In the clinical trials it was found that the majority of the participants were already taking aspirin as a preventative measure against suffering a heart attack. Consequently the effects of taking folic acid were negligible as patients were already receiving the benefit of lower homocysteine from the aspirin.

Most patients in the study had already suffered one heart attack. When they were put on a trial of folic acid, there was minimal benefit with just 6 per cent of the participants showing an observed risk reduction.

However, when the trials were divided into groups reflecting those who previously took aspirin and those who did not, the observed risk reduction was increased to 15 per cent if no one had been taking aspirin previously.

Although the clinical trial evidence appeared to be negative, folic acid still has a benefit to people who have not already had a heart attack, as they would generally not be taking aspirin. However, in these clinical trials taking folic acid after a heart attack appeared to have little effect in preventing a further heart attack as the aspirin was already lowering homocysteine levels.


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