Low serum folate concentrations are associated with an excess incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study

Abstract

Objective: To test the hypothesis that low serum folate concentrations are associated with an increased risk of acute coronary events in men free of prior coronary heart disease. Setting: Research Institute of Public Health, University of Kuopio, Kuopio, Finland. Design: Prospective study in a cohort of 734 men aged 46 ± 64 y examined in 1991 ± 1993 as part of the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) and followed for 5 y and 3 months. Intervention: Acute coronary events during the follow-up period were obtained by national hospital discharge registry. Baseline serum folate concentrations were measured by radioimmunoassay. Results: During the follow-up, six (2.5%) men with higher serum folate concentrations (highest third b11.3 nmola1) and 28 (5.7%) men with lower serum folate (two lowest thirds) developed an acute coronary event (P 0.008). In a Cox model adjusting for age, examination years, and plasma lycopene concentration, in men with higher serum folate concentrations the relative risk for an acute coronary event was 0.31 (95% CI 0.11 ± 0.90, P 0.031) when compared with men with lower serum folates. Conclusion: This prospective cohort study in middle-aged men from eastern Finland indicates that moderate-tohigh levels of serum folate are associated with a greatly reduced incidence of acute coronary events.

Vitamins B6 and B12 and folate status in an adult Mediterranean population

“…Vitamins B 6 and B 12 and especially folate are known to determine plasma concentrations of homocysteine; moderate increases in circulating concentrations of homocysteine are related with cerebrovascular and coronary heart disease (Stampfer et al, 1992;Selhub & Miller, 1993;Voutilainen et al, 2000). These are the most frequent causes of death in our study area (Instituto de Estadística de Andalucía (IEA), 2001).…”

Nutritional B vitamin deficiency alters the expression of key proteins associated with vascular smooth muscle cell proliferation and migration in the aorta of atherosclerotic apolipoprotein E null mice

“…However, there is evidence for folate alone influencing human vascular disease. High circulating folate is associated with reduced risk of primary coronary events and carotid intima-media thickness independently of total plasma homocysteine in several prospective human studies (Voutilainen et al 2000(Voutilainen et al , 2004Durga et al 2005). Moreover, supplemental folic acid positively influences vascular function in patients with, or at risk of, vascular disease (Mangoni et al 2005;Tawakol et al 2005;Till et al 2005).…”

“…Low dietary folate is strongly associated with an increased risk of human vascular diseases including atherosclerosis and stroke (Voutilainen et al 2000(Voutilainen et al , 2004Durga et al 2005). This has been attributed primarily to suboptimal intracellular folate, together with low levels of vitamins B 12 and B 6 , inducing hyperhomocysteinemia (Splaver et al 2004).…”

Do dietary patterns in older men influence change in homocysteine through folate fortification? The Normative Aging Study

“…However, thus far, most studies have focused on the homocysteine-lowering effects of folate (5,28) . Recently, benefits of folate independent of homocysteine lowering have been reported (36)(37)(38)(39)(40)(41)(42) . For example, Voutilainen et al showed that moderate-to-high serum folate concentrations were associated with a greatly reduced incidence of acute coronary events (41) .…”