Folic Acid Reduces Risk of Heart Disease in Elderly

Elderly people who take a daily supplement of folic acid may lower blood homocysteine levels, according to a new study published in the Quarterly Journal of Medicine.¹ An elevated blood homocysteine level is an independent risk factor for cardiovascular disease, stroke, and blood clots. While several studies have shown that supplemental folic acid lowers high homocysteine in younger populations,^{2 3} this is the first study to demonstrate it has a similar effect in the elderly.

This six-week controlled trial included 368 participants between the ages of 65 and 75. Individuals were assigned to one of six groups, each receiving a daily folic acid supplement (containing 50 mcg, 100 mcg, 200 mcg, 400 mcg, or 600 mcg) or a placebo. Blood homocysteine, vitamin B12 status, and dietary intake of folic acid were periodically measured and recorded.

The researchers found that only those taking 400 mcg or 600 mcg of daily supplemental folic acid had a significant reduction in homocysteine levels, compared with individuals taking a placebo. Homocysteine also dropped in people taking 200 mcg, though not by a statistically significant amount. However, as the authors noted, the duration of the study was relatively short, so it is possible that 200 mcg per day of supplemental folic acid would have lowered homocysteine if taken for a longer period.

Assessment of folic acid intake from food showed that men averaged 305 mcg per day and women averaged 308 mcg per day. The results of this study suggest that a total folic acid intake (from food and supplements) of 900 to 1,000 mcg per day is required to ensure 95% of the elderly population would be without cardiovascular risk from elevated homocysteine resulting from folic acid deficiency. Since it is extremely difficult to obtain that much folic acid from food alone, an additional 600 mcg per day of supplemental folic acid would be necessary to reach the target amount.

Nutritional deficiencies are common in the elderly and are associated with poor diet or conditions that interfere with absorption of food. One study found that 40% of elderly Americans were deficient in folic acid and that 84% of them had abnormally high homocysteine.⁴ For the millions of older people with high homocysteine, taking a daily supplement containing 400 to 600 mcg of folic acid may provide nutritional insurance in the prevention of serious heart disease.

References:

1. Rydlewicz A, Simpson JA, Taylor RJ, et al. The effect of folic acid supplementation on plasma homocysteine in an elderly population. Q J Med 2002;95:27–35.
2. Tice JA, Ross E, Coxson PG et al. Cost-effectiveness of vitamin therapy to lower plasma homocysteine levels for the prevention of coronary heart disease. JAMA 2001;286:936–43.
3. Quinlivan EP, McPartin J, McNulty H, et al. Importance of both folic acid and vitamin B12 in reduction of risk of vascular disease. Lancet 2002;359:227–8.
4. Selhub J, Jacques PF, Wilson PW, et al. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA 1993;270:2693–8.

Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of Garlic and Cholesterol: Everything You Need to Know (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice in Westport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.

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