Riboflavin offers a targeted strategy for managing hypertension in patients with the MTHFR 677TT genotype: a 4-y follow-up.
What this study found
Riboflavin lowered blood pressure in the MTHFR 677TT group, and the effect persisted across the 4-year follow-up despite changes in antihypertensive therapy. There was a significant time × treatment interaction for systolic blood pressure (P = 0.028) and diastolic blood pressure (P = 0.018), and post hoc testing showed decreases with riboflavin for both systolic blood pressure (P = 0.001) and diastolic blood pressure (P = 0.003). Across the combined 2004 and 2008 interventions, systolic blood pressure decreased by 9.2 mm Hg and diastolic blood pressure by 6.0 mm Hg. Riboflavin status also…
- Study & population
- Nested riboflavin-placebo crossover follow-up in white patients with cardiovascular disease who were genotyped for MTHFR 677C/T and focused on the TT subgroup.
- Intervention
- Riboflavin was given orally at 1.6 mg/day for 16 weeks, compared with placebo, in MTHFR 677TT participants.
- Key limitation
- The TT subgroup was small, limiting precision and generalizability.
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Open PDFOriginal abstract
BACKGROUND We recently reported that the elevated blood pressure (BP) observed in patients with cardiovascular disease who are homozygous for the 677C→T polymorphism (TT genotype) in the gene encoding methylenetetrahydrofolate reductase (MTHFR) was responsive to supplementation with riboflavin-the cofactor for MTHFR. OBJECTIVE The objective was to investigate the effect of riboflavin on BP targeted at patients with the TT genotype 4 y after initial investigation, during which time major changes in the clinical guidelines for antihypertensive therapy were introduced. DESIGN A total of 83 patients (representing all 3 genotypes) who participated in a placebo-controlled riboflavin intervention for 16 wk in 2004 agreed to take part. Nested within this follow-up, those with the TT genotype (n = 31) proceeded to intervention with riboflavin (1.6 mg/d for 16 wk) or placebo, conducted in a crossover style whereby the 2004 treatment groups were reversed. RESULTS At follow-up in 2008, as in 2004, patients with the TT genotype had higher systolic BP (P < 0.01), with a nonsignificant trend noted for higher diastolic BP (P = 0.051). Despite the marked changes in antihypertensive therapy that had occurred, BP remained unchanged in patients with the TT genotype at the time of follow-up. Riboflavin supplementation (administered in 2004 and 2008) produced an overall decrease in systolic (-9.2 ± 12.8 mm Hg; P = 0.001) and diastolic (-6.0 ± 9.9 mm Hg; P = 0.003) BP. CONCLUSIONS Optimizing riboflavin status offers a low-cost targeted strategy for managing elevated BP in this genetically at-risk group. These findings, if confirmed in the general population, could have important implications for the prevention of hypertension.