Effects of 2-year vitamin B12 and folic acid supplementation in hyperhomocysteinemic elderly on arterial stiffness and cardiovascular outcomes within the B-PROOF trial

被引：49

作者：

van Dijk, Suzanne C. ^{[1
]}

Enneman, Anke W. ^{[1
]}

Swart, Karin M. A. ^{[2
]}

van Wijngaarden, Janneke P. ^{[3
]}

Ham, Annelies C. ^{[1
]}

Brouwer-Brolsma, Elske M. ^{[3
]}

van der Zwaluw, Nikita L. ^{[3
]}

Blom, Henk J. ^{[4
]}

Feskens, Edith J. ^{[3
]}

Geleijnse, Johanna Marianna ^{[3
]}

van Schoor, Natasja M. ^{[2
]}

Dhonukshe-Rutten, Rosalie A. M. ^{[3
]}

de Jongh, Renate T. ^{[5
]}

Lips, Paul ^{[2
,5
]}

de Groot, Lisette C. P. G. M. ^{[3
]}

Uitterlinden, Andre G. ^{[1
,6
]}

Smulders, Yvo M. ^{[7
]}

van den Meiracker, Anton H. ^{[1
]}

Raso, Francesco U. S. Mattace ^{[1
]}

van der Velde, Nathalie ^{[1
,8
]}

机构：

[1] Erasmus MC, Dept Internal Med, NL-3000 CA Rotterdam, Netherlands

[2] Vrije Univ Amsterdam, Med Ctr, EMGO Inst Hlth & Care Res, Dept Epidemiol & Biostat, Amsterdam, Netherlands

[3] Wageningen Univ, Div Human Nutr, NL-6700 AP Wageningen, Netherlands

[4] Vrije Univ Amsterdam, Med Ctr, Dept Clin Chem, Amsterdam, Netherlands

[5] Vrije Univ Amsterdam, Med Ctr, Dept Internal Med, Amsterdam, Netherlands

[6] Netherlands Consortium Healthy Ageing, Rotterdam, Leiden, Netherlands

[7] Vrije Univ Amsterdam, Med Ctr, Inst Cardiovasc Res ICaR VU, Amsterdam, Netherlands

[8] Univ Amsterdam, Acad Med Ctr, Dept Internal Med, Sect Geriatr, NL-1105 AZ Amsterdam, Netherlands

来源：

JOURNAL OF HYPERTENSION | 2015年 / 33卷 / 09期

关键词：

arterial stiffness; cardiovascular disease; cerebrovascular disorders; homocysteine; nutrition; trials; ENHANCES ENDOTHELIAL FUNCTION; AORTIC STIFFNESS; PLASMA HOMOCYSTEINE; BLOOD-PRESSURE; MORTALITY; THICKNESS; THERAPY; DISEASE;

D O I：

10.1097/HJH.0000000000000647

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Introduction: Hyperhomocysteinemia is an important cardiovascular risk indicator in the oldest old, and is associated with elevated arterial stiffness in this age group. Since several intervention trials reported a lack of benefit of B-vitamin supplementation on cardiovascular outcomes, we aimed to investigate the effect of B-vitamin supplementation on arterial stiffness and atherosclerosis in hyperhomocysteinemic elderly patients. Methods: The B-PROOF study is a double-blind, randomized controlled trial, including 2919 elderly aged at least 65 years, with hyperhomocysteinemia (12-50mol/l), treated with B-vitamins (500g vitamin B12 and 400g folic acid) or placebo for 2 years. In a subgroup (n=569), the effect of B-vitamins on pulse wave velocity (PWV) was investigated as a measurement of arterial stiffness. To measure atherosclerosis, carotid intima-media thickness (IMT) measures had been used. Incidents of cardiovascular and cerebrovascular events were determined via structured questionnaires, and blood pressure was also measured. Results: Compared to placebo, B-vitamin supplementation lowered serum homocysteine by 3.6mol/l (P<0.001). Analysis of covariance showed no effect of supplementation on PWV levels, and this was not different for patients without increased arterial stiffness at baseline. Furthermore, no effect on carotid IMT was observed. Discussion: Vitamin B12 and folic acid supplementation in hyperhomocysteinemic elderly patients have no effect on PWV or carotid IMT. Further research will still be necessary to unravel the effects and pathways of homocysteine-lowering treatment on cardiovascular outcomes.

引用

页码：1897 / 1906

页数：10

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