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Health News Archive 49 - Stroke
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• Folate and B12 Cut Post-Stroke Hip Fracture Risk

• Folic Acid Reduces Stroke Risk in Men

Folate and B12 Cut Post-Stroke Hip Fracture Risk

Supplementation with a combination of folate and vitamin B12 appears to cut the risk of hip fracture after stroke in elderly men and women, according to Japanese researchers. Stroke is known to increase the risk of subsequent hip fracture by up to four times, while hyperhomocysteinemia is a risk factor for both ischemic stroke and osteoporotic factors, leading the researchers to investigate whether the B vitamins could reduce the risks.

A total of 559 patients completed the double blind, randomized controlled study and two-year follow up. After ischemic stroke, patients received either 5 mg/d of folate and 1,500 mcg/d of mecobalamin or a double placebo. After two years, plasma homocysteine levels decreased by 38 percent in the treatment group and increased 31 percent in the placebo group. The number of hip fractures per 1,000 patient years was four times higher in the placebo group (43) than the treatment group (10), with researchers reporting a 7.1-percent decline in absolute risk reduction for hip fracture.

The findings were published in the March 2, 2005 issue of The Journal of the American Medical Association (JAMA, 293, 9:1082-8, 2005) (http://jama.ama-assn.org).
 

Folic Acid Reduces Stroke Risk in Men

Men who consume above 800 mcg of folic acid are at significantly lower risk of ischemic stroke, the most common type of stroke, research shows.

During the 14-year-long Health Professionals Follow-Up study, men with the highest intake of folic acid were almost 30 percent less likely to develop an ischemic stroke -- caused by a blocked blood vessel - than men with the lowest folic acid intake. The study included 43,732 men between the ages of 40 and 75.  The results were published in the January 2004 issue of the American Heart Association journal Stroke.

Study author Dr. Ka He of Northwestern University in Illinois said that this is not the first report to demonstrate that folic acid can reduce the risk of stroke. All told, the results appear conclusive and consistent enough to suggest that men change their behavior to protect their health, Dr. He noted. "I believe we should recommend men to increase their intake of folate to reduce stroke risk," He said. Dr. He added that the recommended dietary allowance for folic acid in adults is only 400 micrograms per day, which men can get from their diet or a supplement.

Previous research has shown that extra amounts of folic acid help reduce levels of homocysteine, an amino acid, which certain studies have suggested can decrease a person's risk of having a stroke. It has been shown that an excess of homocysteine, which the body makes when it absorbs and uses protein, can somehow weaken the walls of the arteries. Previous analyses of nutritional surveys of almost 10,000 adults conducted between 1971 and 1975 suggested that people who get enough folate in their diets seem to have a lower risk of stroke than those who eat fewer folate-rich foods.

During the follow-up period, 725 strokes occurred, 455 of which were ischemic. Men who consumed the most folic acid -- half of them had intakes over 821 micrograms per day -- had a significantly lower risk of ischemic stroke than men who consumed the least amount folic acid (around 262 micrograms each day or less). Folic acid intake had no effect on men's risk of hemorrhagic stroke.

The protective benefit of folate and vitamin B12 against stroke could be due to their inverse association with blood homocysteine, which may damage the blood vessels by accumulating in the endothelial cells and generating free radicals. Earlier studies have determined that elevated plasma homocysteine is a risk factor for ischemic stroke. While vitamin B6 levels have also been correlated with homocysteine levels, the association is less strong than that of folate and vitamin B12.

SOURCE: Stroke, January 2004.

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