Decrease of carotid intima-media thickness in patients at risk to cerebral ischemia after supplementation with folic acid, Vitamins B6 and B12

• Published in: Atherosclerosis 2005-07, Vol.181 (1), p.131-135
• Main Authors: Till, Uwe, Röhl, Peter, Jentsch, Almut, Till, Heiko, Müller, Andreas, Bellstedt, Klaus, Plonné, Dietmar, Fink, Horst S., Vollandt, Rüdiger, Sliwka, Ulrich, Herrmann, Falko H., Petermann, Henning, Riezler, Reiner
• Format: Article
• Language: English
• Subjects: Aged; Atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Brain Ischemia - prevention & control; Cardiology. Vascular system; Cardiovascular system; Carotid Arteries - diagnostic imaging; Cerebral ischemia; Coronary heart disease; Double-Blind Method; Female; Folic Acid - therapeutic use; Heart; Homocysteine; Homocysteine - blood; Humans; Intima-media thickness; Intracranial Arteriosclerosis - diagnostic imaging; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Risk Factors; Tunica Intima - diagnostic imaging; Tunica Media - diagnostic imaging; Ultrasonography; Vasodilator agents. Cerebral vasodilators; Vitamin B 12 - therapeutic use; Vitamin B 6 - therapeutic use; Vitamin supplementation
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2004.12.043

Hyperhomocysteinemia is associated with atherosclerotic risk. Although vitamins can lower homocysteine (Hcy), information about effects on atherosclerosis is scarce. We used carotid intima-media thickness (IMT) as an accepted marker of atherosclerotic changes. Fifty patients (60 ± 8 years) with IMT ≥ 1 mm were included. In a double blind, randomized trial they received daily 2.5 mg folic acid, 25 mg Vitamin B6, and 0.5 mg Vitamin B12 or placebo for 1 year. In the treatment group, Hcy decreased from 10.50 ± 3.93 to 6.56 ± 1.53 μmol/l ( P < 0.0001), whereas it remained unchanged in the placebo group (10.76 ± 2.36 versus 10.45 ± 3.30 μmol/l). IMT decreased from 1.50 ± 0.44 to 1.42 ± 0.48 mm ( P = 0.034) in the treatment group, whereas it increased from 1.47 ± 0.57 to 1.54 ± 0.71 mm in the placebo group. The mean individual changes of IMT between both groups differed significantly (−0.08 ± 0.17 versus 0.07 ± 0.25 mm, P = 0.019). Multiple regression analysis revealed that the observed effect on IMT depended only on medication. Vitamin supplementation significantly reduces IMT in patients at risk. This effect is independent of Hcy concentration.