Folic Acid Works To Prevent Stroke When Used In Combination With Hypertension Drugs

New research that's published in the Journal of the American Medical Association shows that folic acid could help to significantly reduce stroke risk in those with high blood pressure who are also taking the hypertension medication enalarpril.

For the study, researchers examined 20,000 adults in China who had dealt with high blood pressure but no history of heart attack or stroke. They found that its combined use of enalapril and folic acid lowered stroke risk when it was compared to the use of enalapril alone. This variation was tested in participants via the MTHFR C677T gene (CC, CT, and TT genotypes), that influences folate levels.

After 4.5 years of treatment, strokes occurred in 2.7 percent of the enalapril-folic acid group when compared with 3.4 percent of participants who took enalapril alone that represent an absolute risk reduction of 0.7 percent and a relative risk reduction of 21 percent. Participants who took folic acid also saw a reduced risk of ischemic stroke and composite cardiovascular events.

The findings suggest a baseline folate level works as an important determinant in the role that's played in stroke prevention and therapy. 

"In this population without folic acid fortification, we observed considerable individual variation in plasma folate levels and clearly showed that the beneficial effect appeared to be more pronounced in participants with lower folate levels," the researchers noted, in a news release. 

However, they also added that due to "limited and inconsistent" data, it is still relatively uncertain what remains on the efficacy of folic acid therapy for the primary prevention of stroke. 

"We speculate that even in countries with folic acid fortification and widespread use of folic acid supplements such as in the United States and Canada, there may still be room to further reduce stroke incidence using more targeted folic acid therapy-in particular, among those with the TT genotype and low or moderate folate levels," they concluded.