Folic acid, vitamin B12 show potential as heart disease treatments

By Bill Gordon

Red wine and garlic aren’t the only dietary supplements that keep our hearts
healthy. Folic acid and vitamin B12 also appear to offer cost-effective
treatments for heart disease and the reduction of associated deaths among the
adult U.S. population, according to projections in a new University of
California, San Francisco study published in the August 22 edition of the
Journal of American Medical Association (JAMA).

“The evidence for the beneficial effects of vitamins B12 and folic acid is much
stronger than for garlic, vitamin E, and other dietary supplements promoted for
heart disease prevention,” says Jeffrey A. Tice, MD, principal investigator of
the study and UCSF assistant adjunct professor of medicine.

UCSF researchers studied available data on the U.S population’s homocysteine
levels, a strong indicator of heart disease risk and associated death. Tice
noted that previous studies demonstrated that people with modestly elevated
homocysteine levels have higher rates of stroke, heart attack, and death from
heart disease compared to those with low to normal homocysteine levels.

In addition, recent randomized clinical trials have shown that folic acid
significantly lowered homocysteine levels by 25 percent and that the addition
of vitamin B12 lowered levels an additional 7 percent. Moreover, homocysteine
levels in the U.S. population have fallen since the Food and Drug
Administration (FDA) mandated in 1998 that all enriched grain products in the
U.S. contain 140 ug of folic acid per 100 g.

Using a computer model, UCSF researchers projected the effects of folic acid
and vitamin B12 on the homocysteine levels of all women and men 35-84 years old
if treated with these dietary supplements over a ten year period from
2001-2011. The costs of using folic acid and B12 vitamins to further lower
homocysteine levels were also studied.

Assuming that the U.S. population consumes their daily dose of grains enriched
with the FDA’s folic acid requirement over a ten year period (2001-2011), the
UCSF study estimated that heart disease rates and deaths will decrease by 8
percent in women and 13 percent in men.

Moreover, among the U.S. population with known heart disease and elevated
homocysteine levels, 310,000 fewer heart disease related deaths are projected
to occur over a ten year period if these people add a folic acid (1 mg) and
vitamin B12 (0.5) supplement to their daily dose of folic acid enriched grains,
rather than consuming folic acid enriched grains alone.

The UCSF study also found that administering daily folic acid and vitamin B12
supplements to everyone with heart disease, as well as to men 45 years and
older without heart disease, should save money.  In women 55 years and older
without heart disease, the cost of vitamin therapy would be low compared to
other treatments currently used. 

“For most people, especially those with heart disease, taking a folic acid and
vitamin B12 supplement is projected not only to be safe and save lives, but
also to save money because it prevents heart disease and the costs associated
with expensive medical treatments and procedures,” said Lee Goldman, MD, senior
author of the study and professor and chair of the UCSF Department of Medicine.

He added that a projected 24 billion dollars in the U.S. would be saved between
2001-2011 by treating men and women with heart disease with folic acid and
vitamin B12. 

Other researchers on the study include Pamela Coxson, PhD, UCSF; Paula A.
Goldman, MPH, and Milton C. Weinstein, PhD, Lawrence Williams, MS, all of the
Harvard School of Public Health, Boston; M.G. Myriam Hunink, MD, PhD, Irwin
Rosenberg, MD, Elizabeth Ross, MD, all of Tufts University.