Randomized controlled trial of homocysteine-lowering vitamin treatment in elderly patients with vascular disease.

Study answer

What this study found

Folic acid plus vitamin B-12 markedly lowered plasma homocysteine, with the greatest effect in participants with lower baseline folate or B-12 status. However, this biochemical improvement did not translate into statistically significant gains in cognitive function or in circulating endothelial or hemostatic markers. Riboflavin and vitamin B-6 did not significantly affect homocysteine or cognition. Overall, the trial found no evidence that lowering homocysteine with these vitamins improves short- to medium-term clinical outcomes in this population.

Study & population

Randomized controlled trial in elderly patients with ischemic vascular disease from two clinical centers.

Intervention

This randomized trial tested oral homocysteine-lowering vitamin regimens for 12 weeks: folic acid 2.5 mg plus vitamin B-12 400 µg daily, riboflavin 25 mg daily, vitamin B-6 25 mg daily, and their combinations.

Key limitation

Each active arm had only 23 participants, limiting power to detect cognitive or vascular event differences.

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Original abstract