Vitamin Intervention for Stroke Prevention Trial

Spence, J. David; Bang, Heejung; Chambless, Lloyd E.; Stampfer, Meir J.

doi:10.1161/01.str.0000185929.38534.f3

Cited by 237 publications

(166 citation statements)

References 39 publications

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“…In light of recent evidence, supplementation with folic acid and B vitamins does not benefit cardiovascular morbidity. It should be noted that B vitamin supplementation confers benefit toward reduction of cerebrovascular events, as seen in the HOPE-2 trial (24), subgroup analysis of the VISP trial (42), and a recent meta-analysis of relevant randomized trials (43). It should also be noted that lowering plasma tHcy with vitamins has a positive effect on cognitive function (44).…”

Section: Discussionmentioning

confidence: 99%

Mesna for Treatment of Hyperhomocysteinemia in Hemodialysis Patients

Urquhart¹,

Freeman²,

Cutler³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: Increased plasma total homocysteine is a graded, independent risk factor for the development of atherosclerosis and thrombosis. More than 90% of patients with end-stage renal disease have hyperhomocysteinemia despite vitamin supplementation. It was shown in previous studies that a single intravenous dose of mesna 5 mg/kg caused a drop in plasma total homocysteine that was significantly lower than predialysis levels 2 d after dosing. It was hypothesized 5 mg/kg intravenous mesna administered thrice weekly, before dialysis, for 8 wk would cause a significant decrease in plasma total homocysteine compared with placebo.Design, setting, participants, & measurements: Patients with end-stage renal disease were randomly assigned to receive either intravenous mesna 5 mg/kg or placebo thrice weekly before dialysis. Predialysis plasma total homocysteine concentrations at weeks 4 and 8 were compared between groups by paired t test.Results Conclusions: It is concluded that 5 mg/kg mesna does not lower plasma total homocysteine in hemodialysis patients and that larger dosages may be required.

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Section: Discussionmentioning

confidence: 99%

Mesna for Treatment of Hyperhomocysteinemia in Hemodialysis Patients

Urquhart¹,

Freeman²,

Cutler³

et al. 2008

Clinical Journal of the American Society of Nephrology

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“…The high dose B-vitamins achieved a better cardioprotective effect than low dose or placebo. In a related study, Spence et al [16] demonstrated a 21% reduction in the risk of stroke, CVD, or death in a high dose B-vitamin group. In the latter study, the exclusion criteria included very low or very high serum B-vitamin levels at baseline, and those already being treated with vitamin B 12 .…”

Section: Figure 3c Schematic Illustration Of the Links Between Deficmentioning

confidence: 95%

“…Many reports [15][16][17][18] indicate that MVD is a significant risk factor for a wide spectrum of CVDs due to the ability to either initiate CVDs or worsen extant impaired cardiovascular function.…”

Section: Pathophysiology Of Mvd-induced Cvdmentioning

confidence: 99%

“…Previous clinical trials of some micronutrients have shown significant correlations between deficiency states and cardiovascular risks/diseases [15,16,17], yet others showed the converse [18]. For instance, the Heart Outcome Prevention Evaluation trial, the Cambridge Heart Antioxidant study, the Norwegian Vitamin Trial, and the Western Norway B Vitamin Intervention trial [19,20,21] showed no clear evidence of benefits from B vitamin supplementation in terms of CVD risk reduction.…”

Section: Introductionmentioning

confidence: 99%

“…These controversies have created confusion among the general public and may have impacted micronutrient intake, leading to fluctuating trends in micronutrient intake across the globe [22,23,24]. Nevertheless, the conflicting research findings could be resolved when one considers the effects of inadequately adjusted covariates, such as disparities in study design and methodologic flaws, including unreliable analytical methods [25,26,27]; variable doses [15]; the use of serum micronutrient measurements that may not adequately reflect long-term micronutrient intake [27,28,29,30]; individual susceptibility factors; type and source of micronutrients; baseline micronutrient level [16], (e.g., very high or very low micronutrient at baseline); environmental factors; micronutrient interactions; inadequate pairing of micronutrients; and many other issues [31]. These have been shown to produce effects similar in magnitude to the observed health effect [14].…”

Section: Introductionmentioning

confidence: 99%

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Micronutrient Vitamin Deficiencies and Cardiovascular Disease Risk: Advancing Current Understanding

Ekpenyong¹

2017

EJPM

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Cardiovascular diseases are responsible for one-third of all deaths in the world. Several factors contribute to the current trend including micronutrient vitamin deficiencies (MVDs), however, opinions regarding the role of MVDs in CVDs are inconsistent; this could impact on micronutrient vitamins intake. The aim of this review was to provide a brief overview of published evidence on the associations between MVDs and CVDs, assess the interactions between micronutrients and cardiovascular endpoints, and identify current related research needs. Literature search conducted on studies published between 1963 and 2016 indicates that MVDs are common and are related to adverse cardiovascular endpoints through various mechanisms, including impaired antioxidant and immune response mechanisms; and anti-inflammatory activities. Some micronutrients directly impact on CVDs; others act as critical cofactors in several biochemical processes. Several methodologic flaws, environmental and individual susceptibility factors, lack of determination of baseline serum levels of complementary micronutrients, absence of uniformly accepted cut-off values, and interactions between micronutrients may partly account for discordant results across studies. Although MVD is a significant risk factor for CVDs, supplementation with single or paired micronutrients for primary prevention of CVDs in healthy adults with no special nutritional needs is discouraged; there is insufficient evidence to determine the benefit/harm of such supplementation.

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