Randomized trials have suggested that folic acid may not have any beneficial effects for preventing heart attacks especially a second episodes. However in a meta-analysis published Wednesday (2/2/11) Wald,et. al. suggest that previous studies have failed to account for the use of aspirin by study participants. The authors suggest folic acid could be a part of a preventative measure to reduce first attacks but not second due to the use of aspirin by those suffering from a previous attack.
The study was published online as part of the PLoS site, an open access peer reviewed site. You can download the study in its entirety here;
Wald DS, Morris JK, Wald NJ (2011) Reconciling the Evidence on Serum Homocysteine and Ischaemic Heart Disease: A Meta-Analysis. PLoS ONE 6(2): e16473. doi:10.1371/journal.pone.0016473
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High homocysteine levels are thought to cause blood cholesterol to become a oxidized low density lipoprotein which is thought to damage arteries. This, along with “silent inflammation”, I feel is the cause for many cardiac conditions as well as other chronic diseases ie. diabetes. Regarding normal homocysteine levels, one must ingest adequate folate hopefully from fruits and vegetables. For some people folate supplements may be needed as indicated with elevated homocysteine levels. For most of us we need to teach our pts. the importance of more fruits and vegetables with less daily saturated fat/red meat intake…….which can equate to less systemic inflammation.