Is there a beneficial effect of folic acid on carotid intima-media thickness?

In a recent article by Fernandez-Miranda et al., it was shown that daily administration of 2.5 mg of folate did not significantly alter carotid-intima media thickness (IMT) in patients with coronary heart disease in respect to coronary patients who did not receive folate, although there was indeed a net reduction of IMT in the former group. This reduction of IMT in the first group would be possibly statistically significant if the control group did not exhibit a similar reduction. The authors attributed the IMT reduction of the control group to the fact that all patients were on hypolipidaemic treatment with statins, whereas the vast majority of them were also on treatment with either beta-blockers or angiotensin-converting enzyme inhibitors or calcium-channels antagonists. As the authors indicate, all these medications have been shown to decrease IMT. It is possible that the effect of folate on IMT was overshadowed by the powerful effect of the combined treatment of statins with the aforementioned cardiovascular drugs. (C) 2008 Elsevier Ireland Ltd. All rights reserved.