Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/46944
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Type: Journal article
Title: Efficacy of B vitamins in lowering homocysteine in older men: Maximal effects for those with B12 deficiency and hyperhomocysteinemia
Author: Flicker, L.
Vasikaran, S.
Thomas, J.
Acres, J.
Norman, P.
Jamrozik, K.
Hankey, G.
Almeida, O.
Citation: Stroke, 2006; 37(2):547-549
Publisher: Lippincott Williams & Wilkins
Issue Date: 2006
ISSN: 0039-2499
1524-4628
Statement of
Responsibility: 
Leon Flicker, Samuel D. Vasikaran, Jenny Thomas, John M. Acres, Paul Norman, Konrad Jamrozik, Graeme J. Hankey and Osvaldo P. Almeida
Abstract: Background and Purpose— A higher plasma concentration of total homocysteine (tHcy) is associated with a greater risk of cardiovascular events. Previous studies, largely in younger individuals, have shown that B vitamins lowered tHcy by substantial amounts and that this effect is greater in people with higher tHcy and lower folate levels. Methods— We undertook a 2-year, double-blind, placebo-controlled, randomized trial in 299 men aged 75 years, comparing treatment with a daily tablet containing 2 mg of folate, 25 mg of B6, and 400 µg of B12 or placebo. The study groups were balanced regarding age (mean±SD, 78.9±2.8 years), B vitamins, and tHcy at baseline. Results— Among the 13% with B12 deficiency, the difference in mean changes in treatment and control groups for tHcy was 6.74 µmol/L (95% CI, 3.94 to 9.55 µmol/L) compared with 2.88 µmol/L (95% CI, 0.07 to 5.69 µmol/L) for all others. Among the 20% with hyperhomocysteinaemia, the difference between mean changes in treatment and control groups for men with high plasma tHcy compared with the rest of the group was 2.8 µmol/L (95% CI, 0.6 to 4.9 µmol/L). Baseline vitamin B12, serum folate, and tHcy were significantly associated with changes in plasma tHcy at follow-up (r=0.252, r=0.522, and r=–0.903, respectively; P=0.003, <0.001, and <0.001, respectively) in the vitamin group. Conclusions— The tHcy-lowering effect of B vitamins was maximal in those who had low B12 or high tHcy levels. Community-dwelling older men, who are likely to be deficient in B12 or have hyperhomocysteinemia, may be most likely to benefit from treatment with B vitamins.
Keywords: aged; clinical trial; homocysteine; vitamins; vitamin B12 deficiency
Rights: © 2006 American Heart Association
RMID: 0020081278
DOI: 10.1161/01.STR.0000198815.07315.68
Published version: http://stroke.ahajournals.org/cgi/content/abstract/37/2/547
Appears in Collections:Public Health publications

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