Oral folic acid enhances endothelial function in patients with hypercholesterolaemia receiving statins

Abstract

Oral administration of folic acid (5 mg) for 4 weeks improves endothelial function in patients with hypercholesterolaemia treated with statins, with possible beneficial effects on the prognosis of these patients.

Folic acid supplementation improves microvascular function in older adults through nitric oxide-dependent mechanisms

“…Specifically, we have recently shown that acutely increasing BH 4 bioavailability through oral administration of sapropterin restores NOdependent vasodilatation in the cutaneous vessels of older adults [13]. Prior studies examining the use of folic acid for improved vascular function suggest that chronic folic acid treatment is capable of improving markers of vessel health in populations with overt cardiovascular disease [14,16,40]. In agreement with these findings, our results suggest that 5 mg of folic acid daily for 6 weeks augments reflex vasodilatation in aged cutaneous vessels throughout heating, and restores skin blood flow to the magnitude observed in young, healthy individuals at the highest temperatures.…”

Effect of Folic Acid and Betaine Supplementation on Flow-Mediated Dilation: A Randomized, Controlled Study in Healthy Volunteers

“…The study from Madhavan et al [ 48 ] found an improvement in FMD only upon supplementation of high doses of folic acid (5 mg/d), but not on supplementation of low doses of folic acid (0.4 mg/d) in coronary artery disease (CAD) patients. Two studies in patients with renal failure [ 52 , 53 ], one study in patients with CAD [ 38 ], one study in patients with peripheral arterial disease [ 54 ], and one study in hypercholesterolemic patients receiving statins [ 55 ] found no effect of folic acid on FMD relative to placebo. Therefore, similar to the finding in healthy volunteers, studies in patients do not convincingly show that folic acid supplementation improves FMD.…”

High-dose folic acid supplementation effects on endothelial function and blood pressure in hypertensive patients: a meta-analysis of randomized controlled clinical trials

“…[6][7][8][9][10][11][12][21][22][23][24][25] Although 45 potentially relevant studies were identified and screened, 33 trials did not meet the eligibility criteria for the meta-analysis. Major reasons for exclusion of studies were (1) cointervention with other therapies (10 trials); (2) nonhypertensive subject populations (6 trials); (3) not randomized (3 trials); (4) a treatment duration of less than 2 weeks or greater than 12 weeks (3 trials); (5) folic acid dose less than 5000 μg (2 trials); (6) use of children as subjects (2 trials); (7) study populations overlapped with other published studies (1 trials); and (8) an absence of data to calculate the net mean change in BP or FMD from baseline to end of follow-up (6 trials).…”

“…Afterward, the pressure is released; and the reactive hyperemia that results, which is due to the increased brachial artery blood flow and subsequent shear stress on the endothelial walls, is imaged and measured using highresolution ultrasound. A number of recent studies have shown that folic acid supplementation can result in a significant improvement in FMD 6,11,21,22 ; however, a couple of studies have shown no such findings, [23][24][25] especially those studies that used low-dose folic acid supplementation (400-800 μg). [26][27][28] To address the inconsistency in the literature, a metaanalysis was conducted recently that showed that folic acid improved endothelial function via improvements in FMD; but this article failed to conduct an analysis on the more traditional clinical measures of systolic and diastolic BP.…”