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The prevalence and correlates of taking folic acid and vitamin supplements among adults aged ≥45 years with CVD

  • Guixiang Zhao (a1), Earl S Ford (a1), Chaoyang Li (a1) and Ali H Mokdad (a2)
Abstract
AbstractObjective

To examine the prevalence and likelihood of taking folic acid or vitamin supplements among adults with CHD or stroke v. adults without these conditions.

Design

A cross-sectional Behavioural Risk Factor Surveillance System survey was conducted in twelve states of the United States and Puerto Rico in 2006. Self-reported data from participants were collected.

Setting

The United States.

Subjects

US non-institutionalised adults (n 41 792), aged ≥45 years.

Results

Of all participants, 5445 had CHD and 2076 had stroke. Significantly higher percentages of women than men reported taking folic acid or vitamin supplements. After adjustment for potential confounders, women with CHD had a significantly lower adjusted prevalence (AP) and adjusted OR (AOR) than women without CHD for taking folic acid less than one time per d (AP = 3·9 % v. 5·5 %; AOR = 0·56; 95 % CI 0·39, 0·81), for taking folic acid one to four times per d (AP = 50·0 % v. 57·5 %; AOR = 0·68; 95 % CI 0·60, 0·79), and for taking vitamin supplements (AP = 60·9 % v. 69·9 %; AOR = 0·66; 95 % CI 0·57, 0·76). Men with CHD had a significantly higher AP (50·4 % v. 46·2 %) and AOR (1·17; 95 % CI 1·02, 1·33) of taking folic acid one to four times per d than men without CHD. In both sexes, adults with stroke were as likely as those without to take these supplements.

Conclusions

Substantial variations in the prevalence and likelihood of taking folic acid or vitamin supplements exist by gender and by CHD status, but not by stroke status.

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Corresponding author
*Corresponding author: Email GZhao@cdc.gov
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1.ES Ford , UA Ajani , JB Croft (2007) Explaining the decrease in US deaths from coronary disease, 1980–2000. N Engl J Med 356, 23882398.

4.ES Ford , SJ Smith , DF Stroup (2002) Homocyst(e)ine and cardiovascular disease: a systematic review of the evidence with special emphasis on case–control studies and nested case–control studies. Int J Epidemiol 31, 5970.

5.NJ Wald , HC Watt , MR Law (1998) Homocysteine and ischaemic heart disease: results of a prospective study with implications regarding prevention. Arch Intern Med 158, 862867.

9.J Ishihara , H Iso , M Inoue (2008) Intake of folate, vitamin B6 and vitamin B12 and the risk of CHD: the Japan Public Health Centre-based Prospective Study Cohort I. J Am Coll Nutr 27, 127136.

10.EB Rimm , WC Willett , FB Hu (1998) Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA 279, 359364.

11.A Tavani , C Pelucchi , M Parpinel (2004) Folate and vitamin B(6) intake and risk of acute myocardial infarction in Italy. Eur J Clin Nutr 58, 12661272.

12.G Schnyder , M Roffi , R Pin (2001) Decreased rate of coronary restenosis after lowering of plasma homocysteine levels. N Engl J Med 345, 15931600.

13.G Schnyder , M Roffi , Y Flammer (2002) Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomised controlled trial. JAMA 288, 973979.

14.LA Bazzano , K Reynolds , KN Holder (2006) Effect of folic acid supplementation on risk of cardiovascular diseases: a meta-analysis of randomised controlled trials. JAMA 296, 27202726.

15.KH Bønaa , I Njølstad , PM Ueland (2006) Homocysteine lowering and cardiovascular events after acute myocardial infarction. N Engl J Med 354, 15781588.

16.M Ebbing , Ø Bleie , PM Ueland (2008) Mortality and cardiovascular events in patients treated with homocysteine-lowering B vitamins after coronary angiography: a randomised controlled trial. JAMA 300, 795804.

17.J Muntwyler , CH Hennekens , JE Manson (2002) Vitamin supplement use in a low-risk population of US male physicians and subsequent cardiovascular mortality. Arch Intern Med 162, 14721476.

18.CM Albert , NR Cook , JM Gaziano (2008) Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomised trial. JAMA 299, 20272036.

20.Q Yang , LD Botto , JD Erickson (2006) Improvement in stroke mortality in Canada and the United States, 1990 to 2002. Circulation 113, 13351343.

22.LA Bazzano , J He , LG Ogden (2002) Dietary intake of folate and risk of stroke in US men and women: NHANES I Epidemiologic Follow-up Study. National Health and Nutrition Examination Survey. Stroke 33, 11831188.

23.V Sepe , G Adamo , MG Giuliano (2007) Folic acid for stroke prevention – author reply 651. Lancet 370, 651.

24.JK Virtanen , S Voutilainen , P Happonen (2005) Serum homocysteine, folate and risk of stroke: Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. Eur J Cardiovasc Prev Rehabil 12, 369375.

25.X Wang , X Qin , H Demirtas (2007) Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. Lancet 369, 18761882.

26.K Radimer , B Bindewald , J Hughes (2004) Dietary supplement use by US adults: data from the National Health and Nutrition Examination Survey, 1999–2000. Am J Epidemiol 160, 339349.

29.DE Nelson , E Powell-Griner , M Town (2003) A comparison of national estimates from the National Health Interview Survey and the Behavioural Risk Factor Surveillance System. Am J Public Health 93, 13351341.

30.J Satia-Abouta , RE Patterson , IB King (2003) Reliability and validity of self-report of vitamin and mineral supplement use in the vitamins and lifestyle study. Am J Epidemiol 157, 944954.

31.TL Bush , SR Miller , AL Golden (1989) Self-report and medical records report agreement of selected medical conditions in the elderly. Am J Public Health 79, 15541556.

32.Y Okura , LH Urban , DW Mahoney (2004) Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. J Clin Epidemiol 57, 10961103.

33.J Satia-Abouta , AR Kristal , RE Patterson (2003) Dietary supplement use and medical conditions: the VITAL study. Am J Prev Med 24, 4351.

34.C Buettner , RS Phillips , RB Davis (2007) Use of dietary supplements among United States adults with coronary artery disease and atherosclerotic risks. Am J Cardiol 99, 661666.

35.A Liem , GH Reynierse-Buitenwerf , AH Zwinderman (2005) Secondary prevention with folic acid: results of the Goes extension study. Heart 91, 12131214.

36.JF Toole , MR Malinow , LE Chambless (2004) Lowering homocysteine in patients with ischaemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomised controlled trial. JAMA 291, 565575.

37.AL Moens , CJ Vrints , MJ Claeys (2008) Mechanisms and potential therapeutic targets for folic acid in cardiovascular disease. Am J Physiol Heart Circ Physiol 294, H1971H1977.

38.C Fernandez-Miranda , M Yebra , JL Aranda (2007) Effect of folic acid treatment on carotid intima-media thickness of patients with coronary disease. Int J Cardiol 118, 345349.

39.G Ntaios , C Savopoulos , A Hatzitolios (2009) Is there a beneficial effect of folic acid on carotid intima-media thickness? Int J Cardiol 135, 260261.

40.K Potter , GJ Hankey , DJ Green (2008) The effect of long-term homocysteine-lowering on carotid intima-media thickness and flow-mediated vasodilation in stroke patients: a randomised controlled trial and meta-analysis. BMC Cardiovasc Disord 8, 2437.

41.U Till , P Rohl , A Jentsch (2005) Decrease of carotid intima-media thickness in patients at risk to cerebral ischaemia after supplementation with folic acid, vitamins B6 and B12. Atherosclerosis 181, 131135.

42.P Poredos (2004) Intima-media thickness: indicator of cardiovascular risk and measure of the extent of atherosclerosis. Vasc Med 9, 4654.

43.C Antoniades , C Shirodaria , N Warrick (2006) 5-Methyltetrahydrofolate rapidly improves endothelial function and decreases superoxide production in human vessels: effects on vascular tetrahydrobiopterin availability and endothelial nitric oxide synthase coupling. Circulation 114, 11931201.

45.C Shirodaria , C Antoniades , J Lee (2007) Global improvement of vascular function and redox state with low-dose folic acid: implications for folate therapy in patients with coronary artery disease. Circulation 115, 22622270.

46.A Tawakol , RQ Migrino , KS Aziz (2005) High-dose folic acid acutely improves coronary vasodilator function in patients with coronary artery disease. J Am Coll Cardiol 45, 15801584.

47.SN Doshi , IF McDowell , SJ Moat (2002) Folic acid improves endothelial function in coronary artery disease via mechanisms largely independent of homocysteine lowering. Circulation 105, 2226.

48.E Setola , LD Monti , E Galluccio (2004) Insulin resistance and endothelial function are improved after folate and vitamin B12 therapy in patients with metabolic syndrome: relationship between homocysteine levels and hyperinsulinemia. Eur J Endocrinol 151, 483489.

49.LM Title , E Ur , K Giddens (2006) Folic acid improves endothelial dysfunction in type 2 diabetes – an effect independent of homocysteine-lowering. Vasc Med 11, 101109.

50.TS Church , CP Earnest , KA Wood (2003) Reduction of C-reactive protein levels through use of a multivitamin. Am J Med 115, 702707.

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Public Health Nutrition
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