TY - JOUR
T1 - Effects of 2-year vitamin B12 and folic acid supplementation in hyperhomocysteinemic elderly on arterial stiffness and cardiovascular outcomes within the B-PROOF trial
AU - van Dijk, S.C.
AU - Enneman, A.W.
AU - Swart, K.M.A.
AU - van Wijngaarden, J.P.
AU - Ham, A.C.
AU - Brouwer-Brolsma, E.M.
AU - van der Zwaluw, N.L.
AU - Blom, H.J.
AU - Feskens, E.J.M.
AU - Geleijnse, J.M.
AU - van Schoor, N.M.
AU - Dhonukshe-Rutten, R.A.M.
AU - de Jongh, R.T.
AU - Lips, P.
AU - de Groot, C.P.G.M.
PY - 2015
Y1 - 2015
N2 - Introduction: Hyperhomocysteinemia is an important cardiovascular risk indicator in the oldest old, and is associated with elevated arterial stiffness in this age group. Since several intervention trials reported a lack of benefit of B-vitamin supplementation on cardiovascular outcomes, we aimed to investigate the effect of B-vitamin supplementation on arterial stiffness and atherosclerosis in hyperhomocysteinemic elderly patients.
Methods: The B-PROOF study is a double-blind, randomized controlled trial, including 2919 elderly aged at least 65 years, with hyperhomocysteinemia (12-50 [mu]mol/l), treated with B-vitamins (500 [mu]g vitamin B12 and 400 [mu]g folic acid) or placebo for 2 years. In a subgroup (n = 569), the effect of B-vitamins on pulse wave velocity (PWV) was investigated as a measurement of arterial stiffness. To measure atherosclerosis, carotid intima-media thickness (IMT) measures had been used. Incidents of cardiovascular and cerebrovascular events were determined via structured questionnaires, and blood pressure was also measured.
Results: Compared to placebo, B-vitamin supplementation lowered serum homocysteine by 3.6 [mu]mol/l (P <0.001). Analysis of covariance showed no effect of supplementation on PWV levels, and this was not different for patients without increased arterial stiffness at baseline. Furthermore, no effect on carotid IMT was observed.
Discussion: Vitamin B12 and folic acid supplementation in hyperhomocysteinemic elderly patients have no effect on PWV or carotid IMT. Further research will still be necessary to unravel the effects and pathways of homocysteine-lowering treatment on cardiovascular outcomes.
AB - Introduction: Hyperhomocysteinemia is an important cardiovascular risk indicator in the oldest old, and is associated with elevated arterial stiffness in this age group. Since several intervention trials reported a lack of benefit of B-vitamin supplementation on cardiovascular outcomes, we aimed to investigate the effect of B-vitamin supplementation on arterial stiffness and atherosclerosis in hyperhomocysteinemic elderly patients.
Methods: The B-PROOF study is a double-blind, randomized controlled trial, including 2919 elderly aged at least 65 years, with hyperhomocysteinemia (12-50 [mu]mol/l), treated with B-vitamins (500 [mu]g vitamin B12 and 400 [mu]g folic acid) or placebo for 2 years. In a subgroup (n = 569), the effect of B-vitamins on pulse wave velocity (PWV) was investigated as a measurement of arterial stiffness. To measure atherosclerosis, carotid intima-media thickness (IMT) measures had been used. Incidents of cardiovascular and cerebrovascular events were determined via structured questionnaires, and blood pressure was also measured.
Results: Compared to placebo, B-vitamin supplementation lowered serum homocysteine by 3.6 [mu]mol/l (P <0.001). Analysis of covariance showed no effect of supplementation on PWV levels, and this was not different for patients without increased arterial stiffness at baseline. Furthermore, no effect on carotid IMT was observed.
Discussion: Vitamin B12 and folic acid supplementation in hyperhomocysteinemic elderly patients have no effect on PWV or carotid IMT. Further research will still be necessary to unravel the effects and pathways of homocysteine-lowering treatment on cardiovascular outcomes.
KW - Arterial stiffness
KW - Cardiovascular disease
KW - Cerebrovascular disorders
KW - Homocysteine
KW - Nutrition
KW - Trials
U2 - 10.1097/HJH.0000000000000647
DO - 10.1097/HJH.0000000000000647
M3 - Article
SN - 0263-6352
VL - 33
SP - 1897
EP - 1906
JO - Journal of Hypertension
JF - Journal of Hypertension
IS - 9
ER -
