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
2008

Long-term effects of B-vitamin supplementation on vascular health in stroke patients

Sample size: 173 publication 10 minutes Evidence: moderate

Author Information

Author(s): Kathleen Potter, Graeme J. Hankey, Daniel J. Green, John Eikelboom, Konrad Jamrozik, Leonard F. Arnolda

Primary Institution: University of Western Australia

Hypothesis

Does long-term homocysteine-lowering treatment with B-vitamins reduce carotid intima-media thickness and increase flow-mediated dilation in stroke patients?

Conclusion

Long-term homocysteine-lowering treatment with B-vitamins did not significantly improve flow-mediated dilation or carotid intima-media thickness in stroke patients.

Supporting Evidence

  • Vitamin-treated group had a significantly lower mean plasma homocysteine concentration than the placebo group.
  • Post-treatment CIMT and FMD did not differ significantly between groups.
  • A meta-analysis suggested B-vitamin supplements should reduce CIMT and increase FMD, but long-term effects were not significant.

Takeaway

Giving stroke patients B-vitamins for a long time didn't help their blood vessels get better, even though it worked for a short time.

Methodology

A randomized, double-blind, placebo-controlled trial measuring carotid intima-media thickness and flow-mediated dilation after at least two years of B-vitamin supplementation.

Potential Biases

Participants may have been a motivated subgroup, potentially affecting generalizability.

Limitations

The study did not measure baseline CIMT and FMD, and only 30% of eligible subjects participated.

Participant Demographics

Participants were mostly male, with a mean age of 65 years and a history of stroke or TIA.

Statistical Information

P-Value

p < 0.001

Confidence Interval

95% CI 7.5 to 8.4 for homocysteine levels

Statistical Significance

p < 0.001

Digital Object Identifier (DOI)

10.1186/1471-2261-8-24

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