Arbor Clinical Nutrition Updates

Brief Report

Stroke prevention - B vitamins

A. Bayir et al. Acute-phase vitamin B12 and folic acid levels in patients with ischemic and hemorrhagic stroke: is there a relationship with prognosis? Neurol Res. 2010 Mar;32(2):115–118.

G. Saposnik et al. Homocysteine-lowering therapy and stroke risk, severity, and disability: additional findings from the HOPE 2 trial. Stroke. 2009 Apr;40(4):1365–72.

K. Potter et al. The effect of long-term homocysteine-lowering on carotid intima-media thickness and flow-mediated vasodilation in stroke patients: a randomized controlled trial and meta-analysis. BMC Cardiovasc Disord. 2008 Sep 20;8:24.

In a nutshell

The association between elevated Hcy, the B vitamins linked to it, and stroke incidence and severity appears strong.

So far, a dozen RCTs, (almost all in patients with significant atherosclerosis), have tried to prevent stroke by reducing Hcy through various combinations of folate, B12 and B6. In only one trial did this clearly succeed.